Randomised, controlled trial on stimulation methods, frequencies and electrode positions to optimize oVEMP measurements in a clinical setting

Introduction:

With regard to the use of oVEMP as a routine testing, issues of optimal statistical results as well as the aspect of time efficiency are of gaining importance. This study tries to compare the parameters of stimulation mode, frequency, electrode position and reproducibility to find an all-round solution for clinical use.

Methods:

Randomized controlled trial with 60 healthy subjects (120 ears), 37 females and 23 males, aged between 19 and 34 years (mean age 24,4 [± 3,2]). After normal hearing and vestibular function was confirmed via a neuro-otologic test-battery, 12 different oVEMP-settings were measured in randomized order, varying stimulation modes (Air-conducted sound (ACS), Bone-conducted vibration (BCV)), frequencies (500 Hz, 1000 Hz) and electrode positions. Upgaze was standardised to 35 ° using a head mounted laser to increase reliability of measurements.

Results:

ACS as well as 500 Hz provided higher amplitudes and SNR compared to BCV or 1000 Hz (each p < 0.001). While electrode position 2 provided highest values for amplitudes, position 1 showed the best data for SNR (each p < 0.001).

Conclusions:

Besides the commonly used clinical standard, setting 2 (combination of ACS, 500 Hz and position 2) with one single “nose reference” offers a serious alternative for clinical use. Not only does it show the highest amplitudes of all settings in this study, it also provides high values for SNR, detection rates and day-to-day-concordance, it reduces the time of investigation and minimizes the risk of mistakes.

PD Dr. med. Achim Georg Beule

HNO Uniklinik Münster,

Kardinal von Galen Ring 10, 48149

Münster

Email: [e-mail]

Publication History

Publication Date:
23 April 2019 (online)