RSS-Feed abonnieren
DOI: 10.3766/jaaa.288ceu
JAAA CEU Program
Volume 28, Number 8 (September 2017)Publikationsverlauf
Publikationsdatum:
26. Juni 2020 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00046128/201708/lookinside/thumbnails/10-3766-jaaa-288ceu_00770-1.jpg)
Questions refer to Portnuff et al, “Safe Use of Acoustic Vestibular-Evoked Myogenic Potential Stimuli: Protocol and Patient-Specific Considerations,” 708–717.
Learner Outcomes:
Readers of this article should be able to:
-
Summarize the risk of hearing loss from high stimulus presentation levels used in testing vestibular evoked myogenic potentials (VEMPs).
-
Discuss how stimulus parameters for recording VEMPs must be evaluated to minimize noise induced hearing loss.
-
Vestibular evoked myogenic potentials (VEMPs) originating from the sternocleidomastoid muscle are:
-
cervical VEMPs (cVEMPs)
-
ocular VEMPs (oVEMPs)
-
triceps VEMPs (tVEMPs)
-
-
Acoustic stimuli considered most effective in eliciting VEMPs are:
-
250 Hz bone conduction clicks
-
500 Hz air conduction tone bursts
-
short duration electrical clicks
-
-
Mattingly et al (2015) observed sudden permanent sensorineural hearing loss after VEMP testing with stimuli of:
-
95 – 100 dB nHL
-
128 and 135 dB pSPL
-
133 dB pSPL
-
-
Price (1981) suggested that for ears at the 25th percentile of susceptibility, the critical level for instantaneous damage by impulsive noises was:
-
132 dB pSPL
-
136 dB pSPL
-
140 dB pSPL
-
-
Based on Beattie and Rochverger (2001), the difference between a “fast response” sound level meter reading of a 500 Hz tone burst, and the actual peak value is approximately:
-
3 dB
-
6 dB
-
12 dB
-
-
To assess risk for acoustic trauma from VEMP stimuli, the authors recommend establishing presentation levels in:
-
dB m
-
dB nHL or dB HL
-
dB pSPL or dB peSPL
-
-
Reducing ear canal volume from 2.0 cc to 1.0 cc changes a stimulus level by a(n):
-
decrease of 6 dB
-
increase of 3 dB
-
increase of 6 dB
-
-
The benefit of VEMP testing might not outweigh the risk for noise induced hearing loss for:
-
cochlear implant candidates
-
elderly patients (> 70 years of age)
-
patients with superior semicircular canal dehiscence (SSCD)
-
-
When SSCD is suspected, VEMP testing:
-
can begin at lower starting presentation levels
-
requires a larger number of trials
-
should not be conducted
-
-
In the authors' protocol for VEMP stimuli designed not to exceed NIOSH noise exposure values, fewer total sweeps are recommended for
-
cVEMPs
-
oVEMPs
-
tVEMPs
-