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Published on: February 21, 2018
Serial cVEMP Testing is Sensitive to Disease Progression in Ménière Patients
Mark J van Tilburg1, Barbara S Herrmann, John J Guinan
1*Department of Otolaryngology, Massachusetts Eye and Ear Infirmary†Department of Otolaryngology, Harvard Medical School‡Department of Audiology§Eaton Peabody Lab, Massachusetts Eye and Ear Infirmary, Massachusetts.
Objective:
To assess the cervical vestibular evoked myogenic potentials (cVEMPs) ability to track disease progression in Ménière's disease patients over time and identify the most sensitive outcome measurement.
Study Design:
Retrospective.
Setting:
Large specialty hospital, department of otolaryngology.
Subjects:
Twenty nine Ménière's patients and seven migraine associated vertigo (MAV) patients.
Intervention:
All patients underwent two cervical vestibular evoked myogenic potential tests at 250, 500, 750, and 1000 Hz with a minimum test interval of 3 months.
Main Outcome Measures:
Threshold, peak-to-peak (PP) amplitude, interaural asymmetry ratio, and effect size.
Results:
In affected Ménière's ears all outcome measures were worse during the second test, for threshold this difference was statistically significant at 750 and 1000 Hz compared with the first test. Compared with young healthy ears the threshold was significantly worse at all frequencies. PP amplitude was significantly decreased at the second test at 750 Hz compared with the first test. In MAV no significant difference between tests was found at any frequency in PP amplitude or threshold. In Ménière's ears, threshold showed a higher first-to-second effect size at 500, 750, and 1000 Hz compared with PP amplitude.
Conclusion:
cVEMP is able to track progression in Ménière's disease over time. Thresholds were the most effective outcome measure to both track progression and to distinguish between MAV and Ménière's patients.
