Vestibular-evoked myogenic potentials in patients with otosclerosis using air- and bone-conducted tone-burst stimulation.

OBJECTIVE: Otosclerosis is a progressive disease with a remodeling process causing ossicular malformation and conductive hearing loss. The aim of this study was to investigate whether vestibular-evoked myogenic potential (VEMP) correlates with the progression of otosclerosis.

DESIGN: Fifteen patients with otosclerosis (21 ears) without operation and 10 healthy subjects (20 ears) underwent VEMP test using air-conducted (AC) and bone-conducted (BC) tone-burst stimulation.

SETTING: Tertiary referral university hospital.

RESULTS: In 21 unoperated otosclerotic ears, 5 ears (24%) showed present AC-VEMPs, and 16 ears had absent AC-VEMPs. Conversely, 16 ears (76%) displayed present BC-VEMPs and 5 ears with absent BC-VEMPs. In those with both AC- and BC-VEMPs, none of them showed air-bone gap greater than 30 dB; in those with absent AC-VEMPs but present BC-VEMPs, 27% of the ears had air-bone gap greater than 30 dB; and in those with absence of both AC- and BC-VEMPs, 80% of the ears revealed air-bone gap greater than 30 dB. Thus, a significant relationship existed among the presence of AC-VEMPs, BC-VEMPs, and magnitude of conductive hearing loss.

CONCLUSION: The presence of an AC-VEMP may indicate an earlier stage of otosclerosis, although absent BC-VEMP infers a later stage. Restated, AC-VEMPs may complement the results obtained with BC-VEMPs to classify the stage of otosclerosis.