4.5 Article

Evaluation of retrootolithic function using galvanic vestibular-evoked myogenic potentials in patients with benign paroxysmal positional vertigo

Journal

EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY
Volume 279, Issue 7, Pages 3415-3423

Publisher

SPRINGER
DOI: 10.1007/s00405-021-07094-9

Keywords

Galvanic vestibular stimulation; Cervical vestibular-evoked myogenic potential; Ocular vestibular-evoked myogenic potential; Benign paroxysmal positional vertigo

Funding

  1. Far Eastern Memorial Hospital [FEMH-2016-C-029]

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By investigating the characteristic parameters and abnormal rates of inner ear tests in BPPV patients, it was found that these patients may have both otolithic and neural dysfunctions, with otolithic organ damage occurring more frequently than retrootolithic neural degeneration.
Purpose The purpose is to investigate possible vestibulopathy in patients with benign paroxysmal positional vertigo (BPPV), inner ear tests, including cervical and ocular vestibular-evoked myogenic potentials (cVEMPs and oVEMPs) via various stimulation modes, were adopted. Methods Fifty BPPV patients were enrolled in this study. All patients underwent pure tone audiometry, cVEMPs, oVEMPs, and caloric tests. The recurrence status, abnormal rates of inner ear tests, and the characteristic parameters of VEMPs, such as wave latencies and amplitudes, were analyzed. Results In affected ears, the abnormal rates of acoustic cVEMPs, vibratory oVEMPs, galvanic cVEMPs, and galvanic oVEMPs were 62%, 28%, 36%, and 14%, respectively. The abnormalities of acoustic cVEMPs were significantly larger than those of vibratory oVEMPs, and acoustic/vibratory VEMPs had significantly higher abnormal rates than the corresponding galvanic VEMPs. Conclusion BPPV patients may have both otolithic and neural dysfunctions. Otolithic organ damage occurs more frequently than retrootolithic neural degeneration, and the saccular macula might have a greater extent of damage than the utricular macula.

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