Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Clin Exp Otorhinolaryngol. 2013 Jun;6(2):57-62. doi: 10.3342/ceo.2013.6.2.57. Epub 2013 Jun 14.
Our goal was to find the clinical value of cervical vestibular evoked myogenic potential (VEMP) in Ménière's disease (MD) and to evaluate whether the VEMP results can be useful in assessing the stage of MD. Furthermore, we tried to evaluate the clinical effectiveness of VEMP in predicting hearing outcomes.
The amplitude, peak latency and interaural amplitude difference (IAD) ratio were obtained using cervical VEMP. The VEMP results of MD were compared with those of normal subjects, and the MD stages were compared with the IAD ratio. Finally, the hearing changes were analyzed according to their VEMP results.
In clinically definite unilateral MD (n=41), the prevalence of cervical VEMP abnormality in the IAD ratio was 34.1%. When compared with normal subjects (n=33), the VEMP profile of MD patients showed a low amplitude and a similar latency. The mean IAD ratio in MD was 23%, which was significantly different from that of normal subjects (P=0.01). As the stage increased, the IAD ratio significantly increased (P=0.09). After stratification by initial hearing level, stage I and II subjects (hearing threshold, 0-40 dB) with an abnormal IAD ratio showed a decrease in hearing over time compared to those with a normal IAD ratio (P=0.08).
VEMP parameters have an important clinical role in MD. Especially, the IAD ratio can be used to assess the stage of MD. An abnormal IAD ratio may be used as a predictor of poor hearing outcomes in subjects with early stage MD.
本研究旨在探讨颈性前庭诱发肌源性电位(VEMP)在梅尼埃病(MD)中的临床价值,并评估 VEMP 结果是否有助于评估 MD 的分期。此外,我们还试图评估 VEMP 在预测听力预后方面的临床效果。
采用颈 VEMP 检测振幅、峰潜伏期和耳间振幅差(IAD)比值。将 MD 的 VEMP 结果与正常对照组进行比较,并将 MD 分期与 IAD 比值进行比较。最后,根据 VEMP 结果分析听力变化。
在临床确诊的单侧 MD(n=41)患者中,IAD 比值异常的颈 VEMP 发生率为 34.1%。与正常对照组(n=33)相比,MD 患者的 VEMP 特征表现为振幅降低和潜伏期相似。MD 患者的平均 IAD 比值为 23%,与正常对照组有显著差异(P=0.01)。随着分期的增加,IAD 比值显著增加(P=0.09)。按初始听力水平分层后,I 期和 II 期(听力阈值为 0-40dB)患者中,IAD 比值异常者的听力随时间下降,与 IAD 比值正常者相比差异有统计学意义(P=0.08)。
VEMP 参数在 MD 中有重要的临床作用。特别是,IAD 比值可用于评估 MD 的分期。IAD 比值异常可能是早期 MD 患者听力预后不良的预测指标。