title: Contribution of Vestibular-Evoked Myogenic Potential (VEMP) testing in the assessment and the differential diagnosis of otosclerosis.
abstract: BACKGROUND
  The aim of this prospective clinical study was to evaluate the clinical importance of Vestibular-Evoked Myogenic Potentials (VEMPs) in the assessment and differential diagnosis of otosclerosis and otologic diseases characterized by "pseudo-conductive" components. We also investigated the clinical appearance of balance disorders in patients with otosclerosis by correlating VEMP results with the findings of caloric testing and pure tone audiometry(PTA).
  
  
  METHODS
  Air-conducted(AC) 4-PTA, bone-conducted(BC) 4-PTA, air-bone Gap(ABG), AC, BC tone burst evoked VEMP, and calorics were measured preoperatively in 126 otosclerotic ears.
  
  
  RESULTS
  The response rate of the AC-VEMPs and BC-VEMPs was 29.36% and 44.03%, respectively. Statistical differences were found between the means of ABG, AC 4-PTA, and BC 4-PTA in the otosclerotic ears in relation to AC-VEMP elicitability. About one-third of patients presented with disequilibrium. A statistically significant interaction was found between calorics and dizziness in relation to PTA thresholds. No relationship was found between calorics and dizziness with VEMPs responses.
  
  
  CONCLUSIONS
  AC and BC VEMPs can be elicited in ears with otosclerosis. AC-VEMP is more vulnerable to conductive hearing loss. Evaluation of AC-VEMP thresholds can be added in the diagnostic work-up of otosclerosis in case of doubt, enhancing differential diagnosis in patients with air-bone gaps. Otosclerosis is not a cause of canal paresis or vertigo.
authors: ENT Surgeon, The Ipswich Hospital, Ipswich, United Kingdom.
authors: Ourania
authors: O
authors: Tramontani
authors: ENT Surgeon, , Tripoli, Greece.
authors: Eleni
authors: E
authors: Gkoritsa
authors: ENT Department of Athens National University, Hippokration Hospital, Athens, Greece.
authors: Eleftherios
authors: E
authors: Ferekidis
authors: ENT Department of Athens National University, Hippokration Hospital, Athens, Greece.
authors: Stavros G
authors: SG
authors: Korres
mesh_terms: D000161:Acoustic Stimulation; D001301:Audiometry, Pure-Tone; D003937:Diagnosis, Differential; D004427:Ear Diseases / Q000175:diagnosis*; D005260:Female; D006115:Greece; D006801:Humans; D008297:Male; D010040:Otosclerosis / Q000175:diagnosis*; D011446:Prospective Studies; D058585:Vestibular Evoked Myogenic Potentials / Q000502:physiology*