Objective: To evaluate the applicability of vestibular-evoked myogenic potentials (VEMPs) in the diagnostics, intraoperative monitoring, and postoperative follow-up of patients in otoneurosurgery.
Study design: A prospective study of patients who underwent either cochlear implantation (CI, n = 18) or were diagnosed with an acoustic neuroma (AN, n = 9) or with neuro(micro)vascular compression of the VIIIth nerve (NVC, n = 27) in the period 2002 to 2004. The follow-up was 1 year for all patients.
Setting: A tertiary-referral unit.
Results: VEMPs could be recorded in 64% of all patients before CI and in 22% after surgery. The patients with AN had normal VEMPs in 22% of all cases when first diagnosed. Normal VEMPs were found in 37% of those patients with NVC. From the 5 AN patients who had to be operated, only 1 had intact VEMPs after surgery. In contrast, after microvascular decompression all patients (4) had normal VEMPs.
Conclusions: VEMPs are helpful in diagnosing patients with vertigo to better identify saccular defects. They are highly sensitive in the early diagnosis of retrocochlear lesions.
Significance: VEMPs can help to reliably identify patients with a retrocochlerar lesion at an early stage and can be used in intraoperative, neurophysiological monitoring.
Ebm rating: C-4.