Vestibular Evoked Myogenic Potentials and Glycerol Testing

Objectives/Hypothesis: The objective was to evaluate dizziness as the first symptom of endolymphatic hydrops, which could provide valuable information on the initial stages of endolymphatic hydrops development. Study Design: The present investigation was specifically designed to establish whether a...

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Bibliographic Details
Published in:The Laryngoscope 2004-02, Vol.114 (2), p.338-343
Main Authors: Magliulo, Giuseppe, Cuiuli, Giuseppe, Gagliardi, Mario, Ciniglio-Appiani, Giuseppe, D'Amico, Raffaello
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Dizziness - diagnosis
Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology
endolymphatic hydrops
Endolymphatic Hydrops - diagnosis
Evoked Potentials, Auditory
Female
Glycerol
glycerol test
Humans
Male
Medical sciences
Meniere Disease - diagnosis
Meniere's disease
Muscle, Skeletal - physiology
Non tumoral diseases
Otorhinolaryngology. Stomatology
Sensitivity and Specificity
Vestibular evoked myogenic potentials
Vestibular Nerve - physiology
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Summary:Objectives/Hypothesis: The objective was to evaluate dizziness as the first symptom of endolymphatic hydrops, which could provide valuable information on the initial stages of endolymphatic hydrops development. Study Design: The present investigation was specifically designed to establish whether a combination of the traditional glycerol test and the vestibular evoked myogenic potential (VEMP) glycerol test is capable of diagnosing endolymphatic hydrops early and to identify potential Meniere's disease. The study was limited to patients who complained of dizziness as their only vestibular symptom. Methods: Thirty‐eight consecutive patients with dizziness who had received no treatment were investigated. Each patient underwent glycerol testing measured with both conventional pure‐tone audiometry and vestibular evoked myogenic potential testing. For the vestibular evoked myogenic potential glycerol test, an increase of more than 20% in both latency and amplitude after glycerol intake was considered an improvement. Results: In one patient, the reappearance of the vestibular evoked myogenic potentials was observed. In another six patients, there was an increase in the vestibular evoked myogenic potential amplitudes, unilaterally in four cases and bilaterally in two. One patient showed a bilateral improvement in amplitude and an unilateral amelioration in latency. Conclusion: The assumption of saccular dilation as a sign of early Meniere's disease was not supported by the literature, which considered saccular hydrops as the final progression of the dilation of the endolymphatic compartments into the cochlea. These data seem to indicate that in our patients a saccular dysfunction rather than an early saccular hydrops has been documented, confirming vestibular evoked myogenic potential testing as an intriguing diagnostic option for a lesion of this structure. The vestibular evoked myogenic potential glycerol test proved capable of identifying dysfunctions of the saccule that were not otherwise detectable by the routine methods. Therefore, the vestibular evoked myogenic potential glycerol test should be considered as an additional method of diagnosis in patients with vertigo or dizziness.
ISSN:0023-852X
1531-4995
DOI:10.1097/00005537-200402000-00030