Vestibular evoked myogenic potentials in acute low-tone sensorineural hearing loss.

OBJECTIVE/HYPOTHESIS: It was the authors' premise that the vestibular evoked myogenic potential (VEMP) test may be used to differentiate acute low-tone hearing loss (ALHL) from Meniere's disease with low-tone HL.

STUDY

DESIGN

Prospective study.

METHODS

From January 2000 to December 2002, consecutive 12 patients with ALHL and another 12 patients with definite Meniere's disease with low-tone HL were enrolled in this study. All patients underwent audiometry and VEMP test, before and after treatment with isosorbide for 3 consecutive months.

RESULTS

Before treatment, 12 patients with ALHL revealed normal VEMPs (11, 92%) and augmented VEMPs (1). After treatment, 11 (92%) patients had resolved to normal hearing within 3 days. One year later, two (17%) patients progressed to Meniere's disease. In comparison with Meniere's disease, 6 (50%) of 12 patients showed normal VEMPs before treatment, and 7 (58%) patients had their hearing improved 3 months after treatment. Comparison of VEMP responses or hearing outcome between both groups exhibited significant differences.

CONCLUSION

Most patients with ALHL reveal normal VEMPs throughout the episode, indicating that the saccule is spared. In contrast, 50% of Meniere's disease patients with low-tone HL demonstrate abnormal VEMPs, showing a significant difference. Therefore, the VEMP test can be used to differentiate ALHL from Meniere's disease with low-tone HL.