Publication: one burst versus chirp in cervical vestibular evoked myogenic potential (CVEMP): comparison between normal and mild to moderate sensorineural hearing loss
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Date
2022
Authors
Salleh, Mohamad Najib
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Abstract
Introduction: The ear is essential for hearing and equilibrium, detecting and analyzing sound, and maintaining balance. These functions are achieved by the action of the cochlear and vestibular organs of the inner ear. Cervical Vestibular evoked myogenic potential (cVEMP) is an electrophysiological modality to assess otolith organs by determining the function of the saccule and its neural connection to a loud auditory stimulus by monitoring the activity of sternocleidomastoid muscle. This study aims to compare the effects of tone burst (TB), upward chirp (UC), and downward chirp (DC) stimulation used in cVEMP on the latency and amplitude of myogenic potentials in normal and mild to moderate sensorineural hearing loss (MMSNHL) Objective: To verify the theory of vestibular evoked myogenic potential (VEMP) generation by investigating the role of cochlear using novel auditory stimuli in normal hearing and mild to moderate (MMSNHL) Methods: In this comparative study, VEMP results of participants with cochlea damage (but normal vestibular function) were compared to that of adults with normal hearing and vestibular function. This study was conducted involving 43 normal ears and 43 ears with mild to moderate SNHL, with participants' ages ranging between 18 and 59 years old by using a random sampling method. The hearing assessment was done using otoscopy examination, tympanometry, conventional pure tone audiometry (PTA), and tone decay. The vestibular assessment was done using the Romberg test, Dix-Hallpike test, video Head Impulse Test (vHIT), and Malay Version of Vertigo Symptom Scale (MVVSS). VEMP recording was done using three different stimuli: 500 Hz tone burst, upward chirp, and downward chirp. Results: There were significant results where the P1 latency and N1 latency were found to be statistically different between the stimuli (p<0.001) in each normal group and the MMSNHL group. However, there were no significant differences in the P1 and N1 latency compared to the normal group and MMSNHL using different stimuli (p>0.05). The P1 and N1 and amplitude were found to be not statistically different between the TB, UP, and DC in each group and between the comparison group of normal and MMSNHL (p>0.05). Conclusion: Downward chirp stimuli was the shortest latency among the three stimuli. However, no significant difference in amplitude between each stimulus in the normal group and MMSNHL. It seems that the cochlear does not significantly contribute to the generation of vemp along with saccule and its central connection compared to normal and MMSNHL
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