Ocular and cervical vestibular-evoked myogenic potentials: a study to determine whether air- or bone-conducted stimuli are optimal.

OBJECTIVES: The aim of this study was to determine whether bone-conducted vibration (BCV) or air-conducted sound (ACS) is the optimal mode for eliciting both ocular vestibular-evoked myogenic potentials (oVEMPs) and cervical VEMPs (cVEMPs).

DESIGN: Twelve healthy volunteers, five patients with unilateral chronic otitis media, and 10 patients with unilateral Meniere disease underwent oVEMP and cVEMP tests using ACS and BCV stimulation modes in a random order.

RESULTS: In healthy controls, BCV mode at Fz had a significantly higher response rate and larger nI-pI amplitude of oVEMPs than that of the ACS mode. In cVEMPs, a significantly higher response rate was noted in BCV mode at inion, when compared with ACS mode. However, no significant difference was noted in the p13-n23 amplitude between these two modes. In five chronic otitis media ears, absence of oVEMPs and cVEMPs in ACS mode and presence of oVEMPs and cVEMPs in BCV mode were shown. In 10 patients with Meniere disease, BCV mode elicited higher response rates of oVEMPs and cVEMPs in the pathological ears than ACS mode did.

CONCLUSIONS: Using BCV mode, Fz and inion may be the optimal sites for eliciting oVEMPs and cVEMPs, respectively. Thus, BCV mode can be substituted for ACS mode to elicit oVEMPs and cVEMPs in the future, especially in "mass detection." In contrast, ACS mode provides an essential clinical merit of site selectivity.