Changes in cochlear function related to acoustic stimulation of cervical vestibular evoked myogenic potential stimulation
Changes in cochlear function related to acoustic stimulation of cervical vestibular evoked myogenic potential stimulation
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DOI：
10.1016/j.heares.2015.12.022
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发表时间：
2016-10-01
期刊：
影响因子：
2.8
通讯作者：
Stenfelt, Stefan
中科院分区：
文献类型：
--
作者：
Stromberg, Anna-Karin;Olofsson, Ake;Stenfelt, Stefan
颈椎诱发肌源性电位（c-VEMP）的评估通常用于临床调查疑似神经症状的患者。需要峰值水平接近130 dB SPL的短强度声刺激来引起响应。最近发表的一篇关于广泛VEMP刺激引起的双侧显著感音神经性听力损失的文章，激发了对引起c-VEMP反应所需的强声刺激对听力敏锐度的直接影响的评估。本研究的目的是研究与c-VEMP测试有关的人类dpoae水平和听力阈值的变化。更具体地说，目前的重点是听力阈值的立即变化和dpoae水平的变化，当使用比以前使用的更短的音调爆发时，频率比声学刺激高0.5个八度。对24例接受神经学检查的听力正常患者进行c-VEMP刺激前后的听力检查。刺激包括192次6 ms的音调爆发，以500 Hz和130 dB peSPL呈现。使用0.125-8 kHz的Bekesy阈值和0.75和3 kHz刺激下的DPOAE I/O生长函数来评估c-VEMP相关的听力状态变化。Bekesy阈值未见明显恶化。c-VEMP刺激后，在0.75 （0.5-1.35 dB）和3 kHz （1.6-2.1 dB）时，DPOAE水平显著降低，耳蜗受压无变化。结果表明，在当前的患者组中，没有立即出现与c-VEMP刺激相关的听力损失。在c-VEMP测试后，在较宽的频率范围内DPOAE水平的显著降低可能与较短的音调爆发刺激有关。结果表明，c-VEMP刺激导致几个频率的DPOAE水平降低，相当于暴露于最大允许的职业噪声8小时工作日后报告的DPOAE水平降低的一半。因此，应避免延长刺激强度或重复刺激c-VEMP测试，以降低噪声性耳蜗损伤的风险。(C) 2015 Elsevier B.V.版权所有
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. (C) 2015 Elsevier B.V. All rights reserved.