Correlation between Cervical Vestibular Evoked Miogenic Potential (C-VEMP) and Hearing Loss Degree in Patients with Meniere’s Disease

Introduction: Ménière's disease (MD) is an idiopathic syndrome characterized by recurrent vertigo, hearing loss and tinnitus.The diagnostic is usually based on the patient's subjective symptoms, such as episodes of vertigo and hearing loss, or physical examination.Hydrops occurs most often in the cochlea, with the saccule as the second most frequent site for endolymphatic hydrops.The cervical vestibular evoked myogenic potential (c-VEMP) test is used in addition to the traditional testing to assess the vestibular system, and provides information about the saccule and inferior vestibular nerve. Main: to find the clinical value of c-VEMP in MD correlating the audiometry and c-VEMP results.Methods: participants selected should have unilateral involvement and definite MD, evaluated by auditory and vestibular functional tests.The criterion for inclusion in the study was altered EcoG at the affected side.C-VEMP was recorded unilaterally at the sternocleidomastoid muscle.Surface electromyographic activity was recorded ipsilaterally, while the patient was instructed to keep lateral head -turning absolutely in sitting position.The other reference and ground electrodes were separately set on the sternum and forehead.The short tone burst (118 dB HL, 1000 Hz, 200 times per stimulus) was conducted to the unilateral ear through a supra aural headphones.Results: There were 30 normal-hearing volunteers (17 men and 13 women; age range 23-65 years, mean 30 years).The study population consisted of 42 patients with unilateral involvement of MD.For the MD group, the c-VEMP mean values were: P13 =15.85 ms (±0.6), N23=23.8ms (±0.38); the average asymmetry index was 27.6%.Normal c-VEMP responses were recorded in 25 (59.5%)patients with DM.Abnormal c-VEMP was recorded in 17 (40.5%).All abnormal responses were found at the same side of the EcoG alteration and hearing loss.From the normal hearing side, c-VEMP abnormalities were not found in all variable, comparing to the control group (p>0.05).The hearing loss stage influenced the number of alterations at the c-VEMP (p<0.05).Conclusion: c-VEMP parameters have an important clinical role in MD and would be a useful method for assessing clinical severity or progression of MD, providing complementary information to that obtained by other diagnostic methods.