Effects of Acoustic Stimuli Used for Vestibular Evoked Myogenic Potential Studies on the Cochlear Function
Effects of Acoustic Stimuli Used for Vestibular Evoked Myogenic Potential Studies on the Cochlear Function
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DOI：
10.1097/mao.0b013e31829ce7b4
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发表时间：
2013-09-01
影响因子：
2.1
通讯作者：
Boetzel, Kai
中科院分区：
文献类型：
--
作者：
Krause, Eike;Mayerhofer, Andreas;Boetzel, Kai
目的：研究用于前庭诱发肌源性电位 (VEMP) 研究的声刺激是否会损害耳蜗。研究设计：前瞻性诊断研究。设置：学术三级转诊中心。方法：在 30 名年龄在 20 至 35 岁之间、没有任何听觉前庭疾病的年轻健康成年人中，在标准环境下进行 cVEMP 研究（突发音、500 Hz、133 dB SPL、刺激率） 200）。在进行 cVEMP 检查的声刺激之前和之后，使用纯音听力测定和失真产物耳声发射 (DPOAE) 测量耳蜗功能。此外，受试者还被询问了耳部症状。结果：所有受试者的 cVEMP 均可被记录。其中八人 (27%) 在 VEMP 检查后立即报告了主观听力症状。第二天，所有人都再次没有投诉。纯音听力测试中的听力阈值并未恶化。在高频范围（4,000-6,000 Hz）内，暴露侧的 DPOAE 水平降低。有主观耳部症状的受试者的水平下降幅度更大。在24小时后的后续测量中，DPOAE水平显示出恢复。结论：用于引发VEMP的声刺激被发现对耳蜗功能有不利影响。我们对健康成年人的研究并未发现临床相关的听力损失。主观听觉症状在24小时内可逆转。尽管如此，刺激水平和重复次数应保持尽可能低。
Objective: To study if acoustic stimuli used for vestibular evoked myogenic potential (VEMP) studies can damage the cochlea.Study Design: Prospective diagnostic study.Setting: Academic tertiary referral center.Methods: In 30 young healthy adults aged between 20 and 35 years without any audiovestibular disorders, cVEMP studies were performed in a standard setting (tone burst, 500 Hz, 133 dB SPL, stimuli rate 200). Before and after acoustic stimulation for the cVEMP examination, the cochlear function was measured using pure tone audiometry and distortion product otoacoustic emissions (DPOAE). Additionally, the subjects were asked about ear symptoms.Results: In all subjects, cVEMP could be recorded. Eight (27%) of them reported subjective hearing symptoms direct after the VEMP examination. All were again free of complaints on the next day. Hearing thresholds did not deteriorate in pure tone audiometry. DPOAE levels decreased on the exposed side in the high-frequency range (4,000-6,000 Hz). The subjects with subjective ear symptoms had a stronger level decrease. In a follow-up measurement 24 hours later, the DPOAE levels showed recovery.Conclusion: Acoustic stimuli used to elicit VEMP were found to have an adverse effect on the cochlear function. A clinically relevant hearing loss was not found in our study in healthy adults. Subjective auditory symptoms were reversible within 24 hours. Nevertheless, the stimulus levels and the number of repetitions should be kept as low as possible.