Involvement of vestibular organs in idiopathic sudden hearing loss with vertigo: an analysis using oVEMP and cVEMP testing.

OBJECTIVE: To investigate the extent of vestibular lesions in idiopathic sudden hearing loss (ISHL) with vertigo.

METHOD: We reviewed the clinical records of 25 consecutive new patients with ISHL with vertigo. We classified patients based on their pattern of vestibular dysfunction. All patients showed cochlear damage and were labeled C (cochlear) type. If a patient showed abnormal cervical vestibular evoked myogenic potential (cVEMP), ocular VEMP (oVEMP) or caloric responses, an S (saccule), U (utricule) or L (lateral semicircular canal) respectively was added to their label.

RESULTS: All patients underwent cVEMPs and caloric tests. Sixteen (64%) and 13 (52%) showed abnormal cVEMPs and caloric responses, respectively, on the affected side. Among the 23 patients who underwent oVEMPs, 10 (43%) showed abnormal oVEMPs on the affected side. Of these 23 patients, 6 (26%) were classified as C type, 4 (17%) as CS type, 1 (4%) as CL type, 1 (4%) as CSU type, 2 (9%) as CSL type, 1 (4%) as CUL type, 8 (35%) as CSUL type.

CONCLUSION: The vestibular end organs close to the cochlea tended to be preferentially affected.

SIGNIFICANCE: It is likely that vestibular dysfunction extends from organs close to the cochlea to those further from the cochlea.