Skip to main content
The Egyptian Journal of Otolaryngology
Download PDF

Assessment of saccular function using cervical vestibular-evoked myogenic potentials in children with sensorineural hearing loss

The Egyptian Journal of Otolaryngology volume 28, pages 234–241 (2012)Cite this article

En

Abstract

Objectives

The aim of this work was to examine saccular function using cervical vestibular-evoked myogenic potentials (cVEMPs) in children with congenital or acquired sensorineural hearing loss (SNHL).

Study design

Descriptive cross-sectional study.

Participants and methods

This study was carried out on 30 children with different degrees of SNHL with normal middle ear function and 25 age-matched and sex-matched typically developing children. All the participants’ age ranged from 5 to 18 years. For each child, the following were administered: history taking, an otologic examination, a basic audiological evaluation in the form of pure tone audiometry and immittancemetry, air-conducted cVEMPs, and computed tomography scan of the temporal bone. The results obtained from the two groups were then compared. In addition, correlation studies between all the results obtained were carried out.

Results

There was a statistically nonsignificant difference between the patients and the controls in cVEMP P13 and N23 latencies, whereas the cVEMP P13–N23 amplitude and threshold results showed a highly significant difference. cVEMP measurements in relation to sex within the patient group showed that the cVEMP threshold was the only positive outcome that showed a significant difference, and was higher in females. There was a highly significant positive correlation between hearing loss and the cVEMP threshold among the patient groups with different degrees of hearing losses. In addition, there was a significant positive correlation between age and cVEMP P13 and N23 latencies among the patient group.

Conclusion

SNHL is associated with saccular dysfunction in the pediatric population in the form of decreased cVEMP P13–N23 amplitudes and elevated cVEMP thresholds. Females presented with higher cVEMP threshold values than men, and cVEMP latencies appear to increase with age. An increase in hearing loss is associated with an increase in the cVEMP threshold and cVEMP amplitude appears to decrease with hearing loss irrespective of its degree. We recommend the inclusion of cVEMPs in the battery of evaluation of children with SNHL to detect early subtle changes in saccular function. Future research focusing on the genes causing SNHL and its relation to VEMP findings should be carried out.

References

  1. Mueller RF, Nehammer A, Middleton A, Houseman M, Taylor GR, Bitner-Glindzciz M, et al. Congenital non-syndromal sensorineural hearing impairment due to connexin 26 gene mutations–molecular and audiological findings. Int J Pediatr Otorhinolaryngol. 1999;50:3–13

    Article  CAS  Google Scholar 

  2. Kim LS, Jeong SW, Lee YM. Cochlear implantation in children. Auris Nasus Larynx. 2010; 37: 6–17

    Article  Google Scholar 

  3. Suarez H, Angeli S, Suarez A, Rosales B, Carrera X, Alonso R. Balance sensory organization in children with profound hearing loss and cochlear implants. Int J Pediatr Otorhinolaryngol. 2007; 71: 629–637

    Article  CAS  Google Scholar 

  4. An M-H, Yi C-H, Jeon H-S, Park S-Y. Age-related changes of single-limb standing balance in children with and without deafness. Int J Pediatr Otorhinolaryngol. 2009; 73: 1539–1544

    Article  Google Scholar 

  5. Zhou G, Kenna MA, Stevens K, Licameli G. Assessment of saccular function in children with sensorineural hearing loss. Arch Otolaryngol Head Neck Surg. 2009; 135: 40–44

    Article  Google Scholar 

  6. Rosengren SM, Todd NPM, Colebatch JG. Vestibular evoked myogenic potentials evoked by brief interaural head acceleration: properties and possible origin. J Appl Physiol. 2009; 107: 841–852

    Article  Google Scholar 

  7. Picciotti PM, Fiorita A, Di Nardo W, Calò L, Scarano E, Paludetti G. Vestibular evoked myogenic potentials in children. Int J Pediatr Otorhinolaryngol. 2007; 71: 29–33

    Article  Google Scholar 

  8. Zagólski O. Vestibular-evoked myogenic potentials and caloric stimulation in infants with congenital cytomegalovirus infection. J Laryngol Otol. 2008; 122: 574–579

    Article  Google Scholar 

  9. Erbek S, Erbek SS, Gokmen Z, Ozkiraz S, Tarcan A, Ozluoglu LN. Clinical application of vestibular evoked myogenic potentials in healthy newborns. Int J Pediatr Otorhinolaryngol. 2007; 71: 1181–1185

    Article  Google Scholar 

  10. Brantberg K. Vestibular evoked myogenic potentials (VEMPs): usefulness in clinical neurotology. Semin Neurol. 2009; 29: 541–547

    Article  Google Scholar 

  11. Kelsch TA, Schaefer LA, Esquivel CR. Vestibular evoked myogenic potentials in young children: test parameters and normative data. Laryngoscope. 2006; 116: 895–900

    Article  Google Scholar 

  12. Rine RM, Braswell J, Fisher D, Joyce K, Kalar K, Shaffer M. Improvement of motor development and postural control following intervention in children with sensorineural hearing loss and vestibular impairment. Int J Pediatr Otorhinolaryngol. 2004; 68: 1141–1148

    Article  Google Scholar 

  13. Goodman A. Reference zero levels for pure tone audiometer. Am Speech Hear Assoc. 1965; 7: 262–263

    Google Scholar 

  14. Valente W, Clarck D, Dickman A. Comprehensive vestibular evaluation battery with normal hearing and hearing impaired children. Eur Arch Otolaryngol. 2005; 155: 1433–1438

    Google Scholar 

  15. Cushing SL, Jordan K, Harrison R. Relationship between sensorineural hearing loss and vestibular and balance function in children. Arch Otorhinolaryngol. 2008; 134: 34–38

    Google Scholar 

  16. Brookhouser PE, Cyr DG, Beauchaine KA. Vestibular findings in the deaf and hard of hearing. Otolaryngol Head Neck Surg. 1982; 90: 773–777

    Article  CAS  Google Scholar 

  17. Huygen PLM, Van Rijn PM, Cremers CWRJ, Theunissen EJJM. The vestibulo-ocular reflex in pupils at a Dutch school for the hearing impaired; findings relating to acquired causes. Int J Pediatr Otorhinolaryngol. 1993; 25: 39–47

    Article  CAS  Google Scholar 

  18. Ochi K, Ohashi T. Age-related changes in the vestibular-evoked myogenic potentials. Otolaryngol Head Neck Surg. 2003; 129: 655–659

    Article  Google Scholar 

  19. Basta D, Todt I, Ernst A. Normative data for P1/N1-latencies of vestibular evoked myogenic potentials induced by air- or bone-conducted tone bursts. Clin Neurophysiol. 2005; 116: 2216–2219

    Article  Google Scholar 

  20. Felipe L, Santos MA, Gonçalves DU. Vestibular evoked myogenic potential (Vemp): evaluation of responses in normal subjects. Pro Fono. 2008; 20: 249–254

    Article  Google Scholar 

  21. Sazgar AA, Dortaj V, Akrami K, Akrami S, Karimi Yazdi AR. Saccular damage in patients with high-frequency sensorineural hearing loss. Eur Arch Otorhinolaryngol. 2006; 263: 608–613

    Article  CAS  Google Scholar 

  22. Todt I, Hennies HC, Basta D, Ernst A. Vestibular dysfunction of patients with mutations of connexin 26. Neuroreport. 2005; 16: 1179–1181

    Article  CAS  Google Scholar 

  23. Tribukait A, Brantberg K, Bergenius J. Function of semicircular canals, utricles and saccules in deaf children. Acta Otolaryngol. 2004; 124: 41–48

    Article  Google Scholar 

  24. Melvin T-AN, Della Santina CC, Carey JP, Migliaccio AA. The effects of cochlear implantation on vestibular function. Otol Neurotol. 2009; 30: 87–94

    Article  Google Scholar 

  25. Tien H-C, Linthicum FH Jr. Histopathologic changes in the vestibule after cochlear implantation. Otolaryngol Head Neck Surg. 2002; 127: 260–264

    Article  Google Scholar 

  26. Basta D, Todt I, Goepel F, Ernst A. Loss of saccular function after cochlear implantation: the diagnostic impact of intracochlear electrically elicited vestibular evoked myogenic potentials. Audiol Neurotol. 2008; 13: 187–192

    Article  CAS  Google Scholar 

  27. Lee SK, Cha CI, Jung TS, Park DC, Yeo SG. Age-related differences in parameters of vestibular evoked myogenic potentials. Acta Otolaryngol. 2008; 128: 66–72

    Article  Google Scholar 

  28. Welgampola MS, Colebatch JG. Vestibulocollic reflexes: normal values and the effect of age. Clin Neurophysiol. 2001; 112: 1971–1979

    Article  CAS  Google Scholar 

  29. Akin FW, Murnane OD, Proffitt TM. The effects of click and tone-burst stimulus parameters on the vestibular evoked myogenic potential (VEMP). J Am Acad Audiol. 2003; 14: 500–509

    Article  Google Scholar 

  30. Rauch SD, Zhou G, Kujawa SG, Guinan JJ, Herrmann BS. Vestibular evoked myogenic potentials show altered tuning in patients with Ménière’s disease. Otol Neurotol. 2004; 25: 333–338

    Article  Google Scholar 

  31. Janky KL, Shepard N. Vestibular evoked myogenic potential (VEMP) testing: normative threshold response curves and effects of age. J Am Acad Audiol. 2009; 20: 514–522

    Article  Google Scholar 

  32. Zapala DA, Brey RH. Clinical experience with the vestibular evoked myogenic potential. J Am Acad Audiol. 2004; 15: 198–215

    Article  Google Scholar 

  33. Ochi K, Ohashi T. Sound-evoked myogenic potentials and responses with 3-ms latency in auditory brainstem response. Laryngoscope. 2001; 111: 1818–1821

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Audiology Unit, ENT Department, Kasr El-Aini Hospital, Cairo University, Cairo, Egypt, P.O. Box 11121

    Mona H. Selim, Shereen M. El-Abd & Mohamed S. El-Minawi

  2. Department of Radiology, Kasr El-Aini Hospital, Cairo University, Cairo, Egypt

    Amr A. F. Nassef

  3. Ministry of Health, Tanta, Egypt

    Beatrice M. Yousef

Authors
  1. Mona H. Selim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shereen M. El-Abd
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohamed S. El-Minawi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Amr A. F. Nassef
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Beatrice M. Yousef
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mona H. Selim.

Additional information

Conflicts of interest

There are no conflicts of interest.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Selim, M.H., El-Abd, S.M., El-Minawi, M.S. et al. Assessment of saccular function using cervical vestibular-evoked myogenic potentials in children with sensorineural hearing loss. Egypt J Otolaryngol 28, 234–241 (2012). https://doi.org/10.7123/01.EJO.0000418053.78780.0c

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.7123/01.EJO.0000418053.78780.0c

Keywords