The Ohio State University, Ohio, USA.
Boys Town National Research Hospital, Omaha, Nebraska, USA.
Ear Hear. 2021 Mar/Apr;42(2):355-363. doi: 10.1097/AUD.0000000000000925.
Bone conduction vibration (BCV) vestibular evoked myogenic potentials (VEMP) are clinically desirable in children for multiple reasons. However, no accepted standard exists for stimulus type and the reliability of BCV devices has not been investigated in children. The objective of the current study was to determine which BCV VEMP method (B-71, impulse hammer, or Mini-shaker) yields the highest response rates and reliability in a group of adults, adolescents, and children. It was hypothesized that the Mini-shaker would yield the highest response rates and reliability because it provides frequency specificity, higher output levels without distortion, and the most consistent force output as compared to the impulse hammer and B-71.
Participants included 10 child (ages 5 to 10), 11 adolescent (ages 11 to 18), and 11 young adult (ages 23 to 39) normal controls. Cervical VEMP (cVEMP) and ocular VEMP (oVEMP) were measured in response to suprathreshold air-conducted, 500 Hz tone bursts and 3 types of BCV (B-71, impulse hammer, and Mini-shaker) across 2 test sessions to assess reliability.
For cVEMP, response rates were 100% for all methods in all groups with the exception of the adult group in response to the impulse hammer (95%). For oVEMP, response rates varied by group and BCV method. For cVEMP, reliability was highest in adults using the Mini-shaker, in adolescents using the impulse hammer, and in children using the B-71. For oVEMP, reliability was highest in adults using the Mini-shaker, in adolescents using the Mini-shaker or impulse hammer, and in children using the impulse hammer. Age positively correlated with air-conducted oVEMP amplitude, but not cVEMP amplitude or cVEMP corrected amplitude. Age negatively correlated with all BCV VEMP amplitudes with the exception of cVEMP corrected amplitude in response to the Mini-shaker.
All BCV methods resulted in consistent cVEMP responses (response rates 95 to 100%) with at least moderate reliability (intraclass correlation coefficient ≥ 0.5) for all groups. Similarly, all BCV methods resulted in consistent oVEMP responses (89 to 100%) with at least moderate reliability (intraclass correlation coefficient ≥ 0.5) except for the B-71 in adults.
骨导振动（BCV）前庭诱发肌源性电位（VEMP）由于多种原因在儿童中具有临床应用价值。然而，目前尚无公认的刺激类型标准，且 BCV 设备的可靠性尚未在儿童中进行研究。本研究的目的是确定在一组成人、青少年和儿童中，哪种 BCV VEMP 方法（B-71、脉冲锤或 Mini-shaker）产生的反应率和可靠性最高。研究假设 Mini-shaker 会产生最高的反应率和可靠性，因为与脉冲锤和 B-71 相比，它提供频率特异性、更高的输出水平而无失真，并且产生最一致的力输出。
参与者包括 10 名儿童（5 至 10 岁）、11 名青少年（11 至 18 岁）和 11 名年轻成人（23 至 39 岁）正常对照。在 2 次测试中，用超阈空气传导、500Hz 短音刺激和 3 种 BCV（B-71、脉冲锤和 Mini-shaker）测量颈性 VEMP（cVEMP）和眼性 VEMP（oVEMP），以评估可靠性。
对于 cVEMP，除了成人组对脉冲锤的反应率为 95%外，所有方法在所有组中的反应率均为 100%。对于 oVEMP，反应率因组和 BCV 方法而异。对于 cVEMP，在使用 Mini-shaker 的成人、使用脉冲锤的青少年和使用 B-71 的儿童中，可靠性最高。对于 oVEMP，在使用 Mini-shaker 的成人、使用 Mini-shaker 或脉冲锤的青少年以及使用脉冲锤的儿童中，可靠性最高。年龄与空气传导性 oVEMP 振幅呈正相关，但与 cVEMP 振幅或 cVEMP 校正振幅无关。年龄与所有 BCV VEMP 振幅呈负相关，除了使用 Mini-shaker 时的 cVEMP 校正振幅。
对于所有组，所有 BCV 方法均产生一致的 cVEMP 反应（反应率为 95%至 100%），至少具有中度可靠性（组内相关系数≥0.5）。同样，除了成人的 B-71 外，所有 BCV 方法均产生一致的 oVEMP 反应（89%至 100%），至少具有中度可靠性（组内相关系数≥0.5）。
