VEMPs: applicazioni cliniche ed esperienza personale.

Abstract

Aim. Among the various techniques to examine the functioning of the vestibular apparatus, the vestibular evoked myogenic potentials (VEMPs) represent a universally accepted methodical and offers significant clinical applications. Methods. The authors studied 93 patients (55 females, 38 males) from 22-83 years (medium age 52.5 years) with cocleovestibular sphere disturbances: deafness, tinnitus and vertigos. All the subjects underwent I and II level audiological examinations: history, clinical observation, tonal liminar audiometry, impedencemetry, acufenometry, clinical and instrumental vestibular exams, acoustics evoked potentials (ABR) and VEMPs. The subject were divided into groups according to pathology, using VEMPs diagnosis and we compared the results with those in the literature. Results. In the 23 cases of neurosensorial hypoacusia, the VEMPs were normal in 91.3% of cases (21 subjects). In the 6 cases of sudden hypoacusia normal results have been obtained in 83.3% of cases. Six cases of peripheral vestibular lesion acute vertigo were diagnosed; the diagnosis has been confirmed by the heatproof which was altered in all cases, whereas VEMPS were altered in 83.3% of cases. All the 8 cases of benign parossistuc positional vertigo (VPPB) showed normal VEMPs. In 4 subjects with the hypoacusia, vertigo and acuphen symptomatology, Meniere’s syndrome was diagnosed; VEMPs were altered in 50% of cases, differently from the heatproof, which was altered in all patients. In the 2 cases with altered VEMPs and heatproof, the clinical pattern presented Meniere’s syndrome in a “macular phase”. In 7 subjects acoustic neurinoma was diagnosed; in all these cases, VEMPs were altered, even in those 3 cases where the disease was associated to a neurosensorial omolateral hypoacusia of moderate entity. Conclusion. These results were compared to the data in the literature and confirm the usefulness of VEMPs in otoneurological diagnosis.