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Diagnostic accuracy of bone-conducted cervical vestibular- evoked myogenic potentials in early infancy: a prospective
Niki Karpeta1, Luca Verrecchia1, Maoli Duan1
1Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, 141 86, Sweden; Department of Otolaryngology Head and Neck Surgery & Audiology and Neurotology, Karolinska University Hospital, Stockholm, 141 86, Sweden.
Insights
Bone-Conducted cervical Vestibular-Evoked Myogenic Potentials (BCcVEMP) accurately assesses infant vestibular function. This method is reliable for early detection, aiding in audiology and neurotology screenings.
Area of Science:
- Neuroscience
- Audiology
- Pediatrics
Background:
- Infant vestibular function assessment presents significant challenges.
- Developing age-appropriate methods for early detection is crucial for identifying potential inner ear impairments.
Purpose of the Study:
- To evaluate the accuracy of Bone-Conducted cervical Vestibular-Evoked Myogenic Potentials (BCcVEMP) for vestibular assessment in newborns and infants.
- To establish normative BCcVEMP wave values in early infancy and compare them with values at one year of age.
Main Methods:
- A cohort of 53 infants (median age 6.4 weeks) with perinatal risk factors for inner ear issues underwent BCcVEMP testing.
- Testing was performed within weeks of birth and repeated at approximately one year of age using the same protocol.
- BCcVEMP wave latencies and amplitudes were analyzed and compared between the two testing periods.
Main Results:
- Vestibular responses were detected in 72.6% of ears in early infancy and 94% at one-year follow-up.
- Wave reproducibility was significantly higher at follow-up.
- P13 and N23 latencies were significantly shorter in one-year-olds compared to infants, with no significant difference in scaled amplitude ratio.
Conclusions:
- BCcVEMP is an accurate and reliable method for assessing vestibular function in infants.
- This technique can be integrated into newborn hearing screening programs.
- Repeat testing is recommended only for infants with initial failed outcomes.
Background/Objectives:
Vestibular function assessment in infants is demanding. To develop age-appropriate methods for vestibular investigation early in infancy and in newborns we studied whether Bone-Conducted cervical Vestibular-Evoked Myogenic Potentials (BCcVEMP) is an accurate method. We also outlined BCcVEMP wave values in early infancy and compared them with values obtained at one year of age in the same cohort.
Materials And Methods:
A total of 53 infants and newborn were included in the study (median age 6.4 weeks, IQR 8.29). Referrals were made to a university-affiliated audiology and neurotology department due to perinatal risk factors for inner ear impairment. The study was conducted between January 2021 and March 2023. We tested BCcVEMP in all participants within a few weeks after birth. The same group was tested again at approximately one year of age with the same protocol. We assessed each ear independently and recorded responses in the number of ears. We calculated and compared BCcVEMP wave latencies and amplitudes between the two test trials.
Results:
We identified vestibular responses in 72.6% of the tested ears (n = 77 ears) during the newborn and early infancy testing and in 94% (n = 92 ears) during the one-year follow up. There was a 75% chance of a response in the first test among the infants with a positive predictive value of 94.5%.Wave reproducibility (WR) was significantly higher at follow-up, while P13, N23 and P13-N23 were significantly shorter than at early in infancy testing; no statistically significant difference was observed in the P13-N13 scaled amplitude ratio between the two time points.
Conclusions:
Our findings support the use of BCcVEMP as an accurate method to confirm vestibular function early in infancy and it can be used for vestibular assessment beside the hearing screening; the test should only be repeated in those cases with a failed outcome.
