The Sensitivity and Specificity of Vestibular Evoked Myogenic Potential (VEMP) in the Diagnosis of Definite Ménière’s Disease Patients

Chanchai Jariengprasert, Suwimol Ruencharoen and Montip Tiensuwan

Department of Otolaryngology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Department of Communication Sciences and Disorders, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Department of Mathematics, Mahidol University, Bangkok, Thailand

^*Correspondance to: Chanchai Jariengprasert 

 PDF  Full Text DOI: 10.25107/2474-1647.1476

Abstract

Objective: this study was retrospectively reviewed the data to compare the sensitivity and specificity of cervical VEMP (cVEMP) between unilateral definite Ménière’s disease (MD) patients, vestibular migraine (VM) and control subjects.Material and
Method: all patients diagnosed as unilateral definite MD, vestibular migraine (VM) patients and normal control adults whom underwent cVEMP tests with short tone burst of 500 Hz. at 95 dBHL during January 2007 – December 2015 were included in this study. Age, gender, routine audiometric and cVEMP results were collected. SPSS package for Microsoft was used in comparison of the percentage and means.Results: the unilateral definite MD group (22 males, 45 females) had mean aged of 50.62±9.41 years and mean pure tone average (PTA) in the affected ears (Rt.ear=37, Lt.ear=30) of 45.95±22.58 dBHL. The VM group (5 males, 51 females) had mean aged of 49.04±9.85 years and mean PTA in Rt. and Lt. Ears of 18.96±7.65 and 19.41±7.96 dBHL, respectively. Normal control adults (13 males, 19 females) had mean aged of 45.47±9.54 years and mean PTA on both ears of 16.02±6.28 dBHL. The percentage of abnormal cVEMP result found in MD was significantly different from those in VM (62.68 vs. 19.64%; X2=23.097, p=0.000) and control group (62.68 vs. 3.12%; X2=31.271, p=0.000). The sensitivity and specificity of cVEMP in MD were 62.68 and 96.88%, respectively.Conclusion: The percentage of abnormal cVEMP in MD was highly significant over those in VM and control groups. Although, the sensitivity of cVEMP in unilateral MD was not dominant than other vestibular test battery in diagnosis of MD, these findings supported more saccular dysfunction, the second most often occurred lesion, in MD than in VM group. However, the high specificity (96.88%) of abnormal cVEMP in MD and VM showed non-specific pathology involving the saccule. The results suggested that cVEMP should be used as a confirmative test or for staging of the disease progression or either in differentiation between MD vs. VM patients, rather than a screening test for detection of hydrops.

Keywords

Cervical vestibular evoked myogenic potential (cVEMP); Ménière’s disease; Vestibular migraine; Sensitivity; Specificity

Cite the article

Jariengprasert C, Ruencharoen S, Tiensuwan M. The Sensitivity and Specificity of Vestibular Evoked Myogenic Potential (VEMP) in the Diagnosis of Definite Ménière’s Disease Patients. Clin Surg. 2017; 2: 1476.