Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, 4 th Floor Diamond Centre, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
Eur Arch Otorhinolaryngol. 2024 Dec;281(12):6333-6338. doi: 10.1007/s00405-024-08860-1. Epub 2024 Aug 5.
While some OVEMP recordings are morphologically straightforward, some are poor in appearance, which can create a challenge, as they often require a "second look" by another experienced assessor. Even OVEMPs in normal subjects are sometimes poorly formed, but we wondered if the morphological assessment of the OVEMP response might provide some additional diagnostic information.
A single experienced assessor evaluated the OVEMP recordings of 60 patients referred sequentially to a tertiary care centre, and categorized them as "easy to assess" (i.e. obvious to a minimally trained assessor) or "difficult to assess", often requiring a second look by another experienced assessor.
In 48 patients, the results were easy to assess (regardless of the actual clinical results) while 12 were classified as "difficult". This figure reflected the rate of morphologically poor responses we found in our population of normative data.
Our clinical concern is that many centres have given up relying on OVEMP assessment because the morphology of the wave may be challenging to interpret. OVEMP assessment often calls for a "second look", requiring a collaboration between two experienced assessors. It seems that this feature may not be diagnostically useful and poor OVEMP morphology may present a challenge in interpretation, but this should not be used as a reason to defer OVEMP testing.
虽然一些 OVEMP 记录在形态上是直接的，但有些则形态不佳，这可能会造成挑战，因为它们通常需要另一位有经验的评估者“再看一眼”。即使是正常受试者的 OVEMP 也有时形态不佳，但我们想知道 OVEMP 反应的形态评估是否可以提供一些额外的诊断信息。
一位经验丰富的评估者对连续转诊到三级保健中心的 60 例患者的 OVEMP 记录进行了评估，并将其分为“易于评估”（即对训练有素的评估者来说显而易见）或“难以评估”，通常需要另一位有经验的评估者进行“再看一眼”。
在 48 例患者中，结果易于评估（无论实际临床结果如何），而 12 例被归类为“困难”。这一数字反映了我们在正常人群的形态数据中发现的形态不良反应的发生率。
我们的临床关注是，许多中心已经放弃依赖 OVEMP 评估，因为波的形态可能难以解释。OVEMP 评估通常需要“再看一眼”，需要两位有经验的评估者之间的协作。似乎这一特征在诊断上没有用处，形态不佳的 OVEMP 可能在解释上构成挑战，但这不应该成为推迟 OVEMP 测试的理由。
