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The application of vestibular-evoked myogenic potentials in otoneurosurgery.

Ernst A, Todt I, Seidl RO, Eisenschenk A, Blödow A, Basta D

Department of Otolaryngology at UKB, Hospital of the University of Berlin (Charité Medical School), Warener Strasse 7, D-12683 Berlin, Germany. ArneborgE@ukb.de

OBJECTIVE: To evaluate the applicability of vestibular-evoked myogenic potentials (VEMPs) in the diagnostics, intraoperative monitoring, and postoperative follow-up of patients in otoneurosurgery. STUDY DESIGN: A prospective study of patients who underwent either cochlear implantation (CI, n = 18) or were diagnosed with an acoustic neuroma (AN, n = 9) or with neuro(micro)vascular compression of the VIIIth nerve (NVC, n = 27) in the period 2002 to 2004. The follow-up was 1 year for all patients. SETTING: A tertiary-referral unit. RESULTS: VEMPs could be recorded in 64% of all patients before CI and in 22% after surgery. The patients with AN had normal VEMPs in 22% of all cases when first diagnosed. Normal VEMPs were found in 37% of those patients with NVC. From the 5 AN patients who had to be operated, only 1 had intact VEMPs after surgery. In contrast, after microvascular decompression all patients (4) had normal VEMPs. CONCLUSIONS: VEMPs are helpful in diagnosing patients with vertigo to better identify saccular defects. They are highly sensitive in the early diagnosis of retrocochlear lesions. SIGNIFICANCE: VEMPs can help to reliably identify patients with a retrocochlerar lesion at an early stage and can be used in intraoperative, neurophysiological monitoring. EBM rating: C-4.

Published 7 August 2006 in Otolaryngol Head Neck Surg, 135(2): 286-90.
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