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Changes in cochlear function related to acoustic stimulation of cervical vestibular evoked myogenic potential stimulation
Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Karolinska Hospital, Sweden.
Karolinska Institute, Sweden.
Karolinska Hospital, Sweden.
Karolinska Hospital, Sweden; Karolinska Institute Stockholm, Sweden.
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2016 (English)In: MEMRO 2015 – Basic science meets clinical otology, Elsevier, 2016, Vol. 340, 43-49 p.Conference paper (Refereed)
Abstract [en]

Evaluation of cervical evoked myogenic potentials (c-VEMP) is commonly applied in clinical investigations of patients with suspected neurotological symptoms. Short intense acoustic stimulation of peak levels close to 130 dB SPL is required to elicit the responses. A recent publication on bilateral significant sensorineural hearing loss related to extensive VEMP stimulation motivates evaluations of immediate effects on hearing acuity related to the intense acoustic stimulation required to elicit c-VEMP responses. The aim of the current study was to investigate changes in DPOAE-levels and hearing thresholds in relation to c-VEMP testing in humans. More specifically, the current focus is on immediate changes in hearing thresholds and changes in DPOAE-levels at frequencies 0.5 octaves above the acoustic stimulation when applying shorter tone bursts than previously used. Hearing acuity before and immediately after exposure to c-VEMP stimulation was examined in 24 patients with normal hearing referred for neurotologic testing. The stimulation consisted of 192 tonebursts of 6 ms and was presented at 500 Hz and 130 dB peSPL. Bekesy thresholds at 0.125-8 kHz and DPOAE I/O growth functions with stimulation at 0.75 and 3 kHz were used to assess c-VEMP related changes in hearing status. No significant deterioration in Bekesy thresholds was detected. Significant reduction in DPOAE levels at 0.75 (0.5-1.35 dB) and 3 kHz (1.6-2.1 dB) was observed after c-VEMP stimulation without concomitant changes in cochlear compression. The results indicated that there was no immediate audiometric loss related to c-VEMP stimulation in the current group of patients. The significant reduction of DPOAE levels at a wider frequency range than previously described after the c-VEMP test could be related to the stimulation with shorter tone bursts. The results show that c-VEMP stimulation causes reduction in DPOAE-levels at several frequencies that corresponds to half the reductions in DPOAE levels reported after exposure to the maximally allowed occupational noise for an 8 h working day. Consequently, extended stimuli intensity or stimulation repetition with c-VEMP testing should be avoided to reduce the risk for noise-induced cochlear injury.

Place, publisher, year, edition, pages
Elsevier, 2016. Vol. 340, 43-49 p.
Hearing Research, ISSN 0378-5955
Keyword [en]
VEMP, Noise, DPOAE, Hearing, Tone burst
National Category
URN: urn:nbn:se:liu:diva-132674DOI: 10.1016/j.heares.2015.12.022ISI: 000386417900006PubMedID: 26724755OAI: diva2:1048305
7th International Symposium on Middle Ear Mechanics in Research and Otology (MEMRO), Aalborg, Denmark, July 1-5, 2015
Available from: 2016-11-21 Created: 2016-11-18 Last updated: 2016-11-28Bibliographically approved

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Strömberg, Anna-KarinStenfelt, Stefan
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Department of Otorhinolaryngology in LinköpingDivision of Neuro and Inflammation ScienceFaculty of Medicine and Health Sciences

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