The hidden dysfunction of otolithic organs in patients with profound sensorineural hearing loss

Abstract

Objective: To define the profiles of ocular and cervical vestibular-evoked myogenic potentials (oVEMP and cVEMP, respectively) in patients with profound sensorineural hearing loss (PSHL).

Methods: Twenty-nine patients with PSHL and 20 healthy volunteers were investigated. The patients' medical records were collected and analyzed. The ACS-evoked oVEMPs and cVEMPs and caloric test were tested and analyzed.

Results: The oVEMP and cVEMP response rates in the patients with PSHL were 38.9% and 44.4%, respectively, and these values were significantly less than those in the healthy volunteers (both were 100%). Regarding the oVEMPs, significantly higher threshold (p < 0.001) and smaller amplitude (p = 0.022) were observed in the patients. Regarding the cVEMPs, a significant elevation in the threshold (p < 0.001) and a decrease in the amplitude (p = 0.024) were observed, and marked reductions in the P1 (p = 0.002) and N1 latencies (p = 0.001) were observed in the patients. Regarding the caloric test, the ratio of semicircular canal dysfunction in patients with PSHL was significantly higher than that in healthy volunteers (p < 0.001). However, neither the patients nor the doctors noticed balance problems or the loss of otolithic function in the summaries of the medical records of all 29 of the patients.

Conclusion: The utricular and saccular dysfunction that can be concealed in patients with PSHL can be observed in oVEMPs and cVEMPs. Otolithic function should receive attention in the diagnosis and treatment of PSHL. VEMPs have special value for the observation of hidden dysfunctions of the otolithic organs of patients with PSHL.

Keywords: Cervical vestibular-evoked myogenic potential (cVEMP); Hearing loss; Ocular vestibular-evoked myogenic potential (oVEMP); Saccule; Utricle; Vestibular function.