Sudden Bilateral Hearing Loss After Cervical and Ocular Vestibular Evoked Myogenic Potentials
Sudden Bilateral Hearing Loss After Cervical and Ocular Vestibular Evoked Myogenic Potentials
复制标题
DOI：
10.1097/mao.0000000000000764
复制
发表时间：
2015-07-01
影响因子：
2.1
通讯作者：
Cass, Stephen P.
中科院分区：
文献类型：
--
作者：
Mattingly, Jameson K.;Portnuff, Cory D. F.;Cass, Stephen P.
目的 颈部和眼前庭诱发肌源性电位（cVEMP 和 oVEMP）通常用于评估神经系统疾病。我们提出了一个在 oVEMP 和 cVEMP 测试后立即出现双侧听力突然丧失的病例。听力损失没有恢复。据我们所知，以前的病例报告没有讨论与 VEMP 测试相关的突发性听力损失，尤其是双侧听力损失。 患者 一名患有突发性双侧听力损失的患者，在 cVEMP 和 oVEMP 后持续存在。 干预 该患者有慢性每日头晕病史。她接受了前庭功能测试，包括 cVEMP 和 oVEMP 测试。 cVEMP 和 oVEMP 测试后立即发现明显的双侧感音神经性听力损失，并通过听力测试确认。尽管使用了口服类固醇，她的听力损失并未恢复。主要结果测量系列听力图，计算每只耳朵的最大总声能。结果 VEMP 前与 VEMP 后听力图显示阈值增加，单词识别分数降低；传递到每只耳朵的总声能显示出显着的声音暴露。 结论 虽然 VEMP 测试被认为是安全且耐受性良好的，但大量的声音可以传递到耳蜗，并且某些人可能容易受到这些级别的声损伤。我们建议在使用多次试验时限制 VEMP 刺激水平并注意总声音暴露。
Objective Cervical and ocular vestibular evoked myogenic potentials (cVEMPs and oVEMPs) are commonly used in evaluation of neurotologic disorders. We present a case of sudden bilateral hearing loss immediately after oVEMP and cVEMP testing. The hearing loss did not recover. To our knowledge, no previous case reports discuss sudden hearing loss, especially bilateral, associated with VEMP testing.Patient A single patient with sudden bilateral hearing loss that has persisted after cVEMP and oVEMP.Intervention The patient had a history of chronic daily dizziness. She underwent vestibular function testing that included cVEMP and oVEMP testing. A significant bilateral sensorineural hearing loss was noted immediately after cVEMP and oVEMP testing and confirmed with audiometric testing. Despite the use of oral steroids, her hearing loss did not recover.Main Outcome Measures Serial audiograms, calculated maximum total sound energies to each ear.Results Pre-VEMP versus post-VEMP audiograms show increased thresholds and decreased word recognition scores; total sound energy delivered to each ear shows significant sound exposure.Conclusion Although VEMP testing is thought to be safe and well tolerated, a significant amount of sound can be delivered to the cochlea, and certain individuals may be susceptible to acoustic trauma at these levels. We recommend limits for VEMP stimuli levels and attention to total sound exposure when multiple trials are used.