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Study Using Click and Galvanic Vestibular Evoked Myogenic Potentials

Shinichi Iwasaki, MD; Yoshinari Takai, MD; Hidenori Ozeki, MD; Ken Ito, MD; Shotaro Karino, MD; Toshihisa Murofushi, MD

Arch Otolaryngol Head Neck Surg. 2005;131:857-862.

Objective  To clarify the extent of the vestibular lesions in idiopathic sudden hearing loss with vertigo using vestibular evoked myogenic potentials (VEMPs) in response to click (click-VEMP) and galvanic (galvanic-VEMP) stimulation, as well as caloric tests.

Design  Retrospective study.

Setting  University hospital.

Patients  We enrolled 22 patients with idiopathic sudden hearing loss with vertigo in this study. All patients underwent audiometry and click-VEMP and caloric tests. Eight patients underwent a galvanic-VEMP test.

Results  Among the 22 patients, 17 (77%) showed an absence of click-VEMPs on the affected side. In response to caloric testing, 10 patients (45%) showed a decreased response on the affected side. All 8 patients who underwent galvanic-VEMP testing showed normal responses. Most patients with decreased caloric responses (9 [90%] of 10 patients) showed an absence of click-VEMPs, whereas 9 (53%) of the 17 patients who showed abnormal click-VEMPs showed decreased caloric responses. Initial hearing level and hearing outcome significantly correlated with abnormalities on the vestibular test results.

Conclusions  The lesion site of vestibular disorders in idiopathic sudden hearing loss with vertigo appeared to be within the labyrinth on the basis of galvanic-VEMP findings. Results of the click-VEMP and caloric tests suggested that the saccule could be involved more frequently than the semicircular canals. The combined use of click-VEMP and caloric tests is useful for evaluating vestibular functions in idiopathic sudden hearing loss with vertigo because the extent of vestibular abnormalities correlated well with hearing outcome.

Author Affiliations: Departments of Otolaryngology, Faculty of Medicine, University of Tokyo (Drs Iwasaki, Takai, Ozeki, Ito, and Karino), and Tokyo Postal Services Agency Hospital (Dr Murofushi), Tokyo, Japan.

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