Evaluation of Cervical and Ocular Vestibular Evoked Myogenic Potentials Results in Acoustic Neuroma Cases
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Abstract
Vestibular evoked myogenic potentials are tests used to evaluate the integrity of the vestibular system. In this study, we aimed to assess cervical and ocular vestibular-evoked myogenic potentials in patients who underwent CyberKnife treatment for vestibular schwannoma.
The study included 23 patients who received Cyberknife treatment for VS and 26 healthy patients without complaints. The patients were given a 97 dB, 500 Hz tone-burst stimulus using monaural air conduction with the ICS-CHARTER EP 200 audiometry device, and cervical and ocular vestibular-evoked myogenic potential tests were applied. In analyzing the results, we assessed the failure rates in obtaining vestibular-evoked myogenic potential responses and the mean and standard deviation values of P1 latency, N1 latency, P1-N1 interval, and P1-N1 interpeak amplitude, and calculated the amplitude asymmetry ratio.
When comparing sick and healthy ears within the patient group, a statistically significant difference in non-response rates was found for both cervical and ocular vestibular-evoked myogenic potential tests. Comparing the patient group to the control group based on the vestibular-evoked myogenic potentials asymmetry rate revealed significant differences in both cervical and ocular vestibular-evoked myogenic potentials. Upon examining the ocular vestibular evoked myogenic potential responses, only a significant difference was noted in P1 latency. When analyzing the patient group by hearing level, ocular vestibular-evoked myogenic potential responses were statistically significantly reduced among patients with hearing levels greater than 60 dB. Conversely, no significant difference was observed as tumor size increased, and abnormalities in cervical vestibular-evoked myogenic potentials and ocular vestibular-evoked myogenic potentials responses also increased in patients with a medial tumor location.
The vestibular-evoked myogenic potential test is a noninvasive, easy-to-perform test method for evaluating vestibular functions in VS patients.
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References
2. Hızal E, Erbek H, Ozlüoğlu L. Vestibular evoked myogenic potentials. Bozok Med J. 2014;1(1):26.
3. Yang T, Young Y. Clinical usefulness of vestibular-evoked myogenic potential testing: a review. J Formos Med Assoc. 2024;124(12):1120. doi:10.1016/j.jfm a.2024.11.008
4. Fröhlich L, Curthoys IS, Kösling S, Obrist D, Rahne T, Plontke SK. Cervical and ocular vestibular-evoked myogenic potentials in patients with intracochlear schwannomas. Front Neurol. 2020;11:549817. doi:10.3389/fneur.2020.549817
5. Lee YF, Lee C, Wang MC, Liu KD, Wu H, Guo W, et al. Cervical vestibular-evoked myogenic potential in vestibular schwannoma after gamma-knife surgery. Auris Nasus Larynx. 2015;42(4):265. doi:10.1016/j.a nl.2015.01.004
6. Prasad D, Steiner M, Steiner L. Gamma surgery for vestibular schwannoma. J Neurosurg. 2000;92 (5):745. doi:10.3171/jns.2000.92.5.0745
7. Tesařová M, Peterková L, Šťastná M, Kolář M, Lacina L, Smetana K, et al. Tumor biology and microenvironment of vestibular schwannoma: relation to tumor growth and hearing loss. Biomedicines. 2022;11(1):32. doi:10.3390/biomedicines11010032
8. Rahne T, Plontke SK, Fröhlich L, Strauß C. Optimized preoperative determination of nerve of origin in patients with vestibular schwannoma. Sci Rep. 2021;11(1). doi:10.1038/s41598-021-87515-1
9. Cal RVR, Bahmad F. Vestibular evoked myogenic potentials: an overview. Braz J Otorhinolaryngol. 2009;75(3):456. doi:10.1016/s1808-8694(15)30666-2
10. Murofushi T, Shimizu K, Takegoshi H, Cheng P. Diagnostic value of prolonged latencies in the vestibular evoked myogenic potential. Arch Otolaryngol Head Neck Surg. 2001;127(9):1069. doi:10.1001/archotol.127.9.1069
11. Nola G, Guastini L, Crippa B, Deiana M, Mora R, Ralli G. Vestibular evoked myogenic potential in vestibular neuritis. Eur Arch Otorhinolaryngol. 2011; 268(11):1671. doi:10.1007/s00405-011-1592-0
12. Baier B, Dieterich M. Vestibular-evoked myogenic potentials in vestibular migraine and Menière’s disease. Ann N Y Acad Sci. 2009;1164(1):324. doi:10.1111/j.1749-6632.2009.03868.x
13. Elmoazen D, Asal S, Ziton SM. Vestibular-evoked myogenic potentials and video head impulse test in cochlear otosclerosis. Egypt J Otolaryngol. 2023;39(1). doi:10.1186/s43163-023-00544-7
14. Sunwoo W, Jeon YJ, Park HG, Song Y, Song J, Choi BY, et al. Silent vestibulopathy in asymmetric hearing loss can be a sign of a cerebellopontine angle tumor. J Otorhinolaryngol Hear Balance Med. 2018;1(1):6. doi:10.3390/ohbm1010006
15. Deniz K, Ünsal S, Kurtaran H. Evaluation of vestibular evoked myogenic potentials test in vitamin B12 deficiency. J Otolaryngol Rhinol. 2020;6(2). doi:10.23937/2572-4193.1510076
16. Godha S, Upadhyay A, Mundra RK, Bhalot L, Singh A. VEMP: an objective test for diagnosing cases of BPPV. Indian J Otolaryngol Head Neck Surg. 2020;72(2):251. doi:10.1007/s12070-020-01802-3
17. Nahrani MH, Akbari M, Sohani SM, Yazdi MM, Maarefvand M. Vestibular evoked myogenic potentials in cervical myofascial pain syndrome. Indian J Otolaryngol Head Neck Surg. 2021;74:3993. doi:10.1007/s12070-021-02772-w
18. Murofushi T. Recording and assessing VEMP. In: Vestibular Evoked Myogenic Potentials: Its Basic and Clinical Applications. Springer; 2009:25-29.
19. Taylor RL, Kong J, Flanagan S, Pogson J, Croxson G, Pohl D. Prevalence of vestibular dysfunction in patients with vestibular schwannoma using video head impulses and vestibular-evoked potentials. J Neurol. 2015.
20. Murofushi T, Matsuzaki M, Mizuno M. Vestibular evoked myogenic potentials in patients with acoustic neuromas. Arch Otolaryngol Head Neck Surg. 1998;124(5):509. doi:10.1001/archotol.124.5.509
21. Kinoshita M, Iwasaki S, Fujimoto C, Inoue A, Egami N, Chihara Y, et al. Ocular vestibular evoked myogenic potentials in response to air-conducted sound and bone-conducted vibration in vestibular schwannoma. Otol Neurotol. 2013;34(7):1342. doi:10.1097/mao.0b013e31828d6539
22. Sreedhar A, Sinha SK. Cervical and ocular vestibular-evoked myogenic potentials test results and relation to vestibular signs and symptoms in vestibular migraine. Egypt J Otolaryngol. 2024; 40(1). doi:10.1186/s43163-024-00610-8
23. Semmanaselvan K, Vignesh SS, Muthukumar R, Jaya V. Vestibular evoked myogenic potentials after Epley’s manoeuvre among individuals with BPPV. Indian J Otolaryngol Head Neck Surg. 2019; 71(2):195. doi:10.1007/s12070-019-01581-6
24. Basta D, Todt I, Ernst A. Characterization of age-related changes in vestibular evoked myogenic potentials. J Vestib Res. 2007;17:93.
25. Lee SK, Il C, Jung TS, Park DC, Yeo SG. Age-related differences in parameters of vestibular evoked myogenic potentials. Acta Otolaryngol. 2007;128(1):66. doi:10.1080/00016480701387108
26. Brantberg K. Vestibular evoked myogenic potentials (VEMPs): usefulness in clinical neurotology. Semin Neurol. 2009;29(5):541. doi:10.1055/s-0029-1241042
27. Patko T, Vidal P, Vibert N, Huy PTB, de Waele C. Vestibular evoked myogenic potentials in unilateral acoustic neuroma: a study of 170 patients. Clin Neurophysiol. 2003;114(7):1344. doi:10.1016/s1388-2457(03)00119-6
28. Ushio M. Click- and short tone burst-evoked myogenic potentials in cerebellopontine angle tumors. Acta Otolaryngol. 2001;121(545):133. doi:10.1080/000164801750388306
29. Chen C, Young Y, Tseng H. Preoperative versus postoperative role of vestibular-evoked myogenic potentials in cerebellopontine angle tumor. Laryngoscope. 2002;112(2):267. doi:10.1097/0000 5537-200202000-00013
30. Tsutsumi T, Tsunoda A, Noguchi Y, Komatsuzaki A. Prediction of the nerves of origin of vestibular schwannomas with vestibular evoked myogenic potentials. J Vestib Res. 2000;21(5):712.