Variance of vestibular-evoked myogenic potentials

Objectives/Hypothesis: Vestibular-evoked myogenic potential (VEMP) has been thought to originate from sacculus. The variance of this potential and the effectiveness of the adjustments of pInII amplitudes using average muscle tonus of ipsilateral sternocleidomastoid muscle were evaluated. in addition, clinical application of VEMP was examined in patients with acoustic tumors (ATs) and vestibular neurolabyrinthitis (VNL). Study Design: Prospective evaluation of the VEMP in 18 normal volunteers and 6 patients. Methods: Variance and left-right difference of each parameter, including pi latency, nII latency, pInII amplitude, and threshold, was analyzed. Input-output function of pInII amplitude was evaluated. Average muscle tonus was calculated in 20 ears and applied for adjustment of pInII amplitude. Sensitivity of each parameter of VEMP was examined in 3 patients with ATs and 3 patients with VNL. Results: VEMP was present in all 36 ears of 18 control subjects. Thresholds of VEMP for normal subjects were 80 to 95 dB normal hearing level (nHL). The muscle tonus affected pInII amplitude significantly; however, no statistically significant improvement was observed in test-retest investigation after adjustment using muscle tonus. The threshold of the affected side was elevated compared with the non-affected side in all patients with ATs, whereas 2 of 3 patients showed normal pInII-ratio. One patient with VNL presented normal VEMP, whereas 2 patients presented no VEMP to the highest stimulus intensity. Conclusions: Interaural difference of thresholds might be the most useful parameters. Adjustment using average muscle tonus is not necessary when the subject is able to get sufficient muscle tonus.