Vestibular Evoked Myogenic Potentials and Wideband Acoustic Immittance as Screening Tools for Large Vestibular Aqueduct Syndrome.

Background: Large vestibular aqueduct syndrome (LVAS) is the most common inner ear malformation in children with hearing loss; however, imaging is required to determine the definitive diagnosis. Purpose: This study aimed to preliminarily determine the sensitivity and specificity of air-conducted and...

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Publicado en:Journal of the American Academy of Audiology Vol. 36; no. 3; pp. 160 - 172
Autores principales: Janky, Kristen L., Patterson, Jessie N., Kelly, Elizabeth A., Merchant, Gabrielle R.
Formato: research tables/charts Journal Article
Publicado: Thieme Medical Publishing Inc. May2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2025
      vid: 36
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      pub: Thieme Medical Publishing Inc.
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        atl: Vestibular Evoked Myogenic Potentials and Wideband Acoustic Immittance as Screening Tools for Large Vestibular Aqueduct Syndrome.
      aug:
        au:
          Janky, Kristen L.
          Patterson, Jessie N.
          Kelly, Elizabeth A.
          Merchant, Gabrielle R.
        affil: Boys Town National Research Hospital, Omaha, NE
      sug:
        subj:
          Evoked Potentials, Motor
          Vestibular Function Tests
          Acoustic Impedance Tests
          Vestibular Aqueduct
          Vestibular Diseases
          Health Screening
          Evoked Potentials, Visual
          Acoustics Evaluation
          Air Conduction
          Bone Conduction
          Human
          Male
          Female
          Child
          Adolescence
          Adult
          Middle Age
          Aged
          Sensitivity and Specificity
          Nonexperimental Studies
          Prospective Studies
          Funding Source
          Tomography, X-Ray Computed
          Magnetic Resonance Imaging
          Audiometry
          Otoscopy
          Data Analysis Software
          Mann-Whitney U Test
          ROC Curve
          Child: 6-12 years
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Background: Large vestibular aqueduct syndrome (LVAS) is the most common inner ear malformation in children with hearing loss; however, imaging is required to determine the definitive diagnosis. Purpose: This study aimed to preliminarily determine the sensitivity and specificity of air-conducted and bone-conducted cervical vestibular evoked myogenic potentials (VEMPs) and ocular VEMPs and wideband acoustic immittance (WAI) as screening tools for LVAS and identify candidates for imaging. Research Design: This was a prospective observational study. Study Sample: The sample included 10 participants (17 ears) with LVAS and 15 control participants. Intervention: All participants completed cervical and ocular VEMP testing in response to air-conducted and bone-conducted stimuli and WAI testing. Results: Ears with LVAS had significantly higher air-conducted cervical and ocular VEMP amplitudes but reduced bone-conducted VEMP amplitudes. Because of this pattern reversal, air-conducted amplitudes were subtracted from bone-conducted amplitudes. This novel outcome was the best individual factor for differentiating ears of the control group from ears with LVAS and is a sensitive clinical indicator of LVAS, with 82 percent sensitivity and 80 percent specificity for cervical VEMP and 88 percent sensitivity and 80 percent specificity for ocular VEMP. Ears with LVAS exhibited significant differences in WAI absorbance of control ears at select low, mid, and high frequencies, and they also exhibited characteristic low-frequency peaks in individual responses that could be detected using an automated algorithm with moderate sensitivity (64 percent) and specificity (72 percent). Conclusions: This is the first report of the use of VEMP and WAI responses of individuals as screening tools for LVAS. VEMP and WAI could be used to determine which individuals are good candidates for radiographic imaging and decrease the time required to determine a diagnosis. The test results also demonstrated patterns that differed from those of other third window disorders. Therefore, important physiologic differences between LVAS and other third window disorders require further investigation.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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