Relationship Between Cervical Vemp (Cvemp) And Ocular Vemp (Ovemp) Parameters As Measured By Click And Tone Burst In Adults With Normal Hearing Sensitivity

Vestibular evoked myogenic potential (VEMP) is one of the clinical tools to evaluate vestibular function. The VEMP can be recorded from sternocleidomastoid muscle by auditory stimulation with various sound stimuli. The aim of this study was to compare parameter of cVEMP and oVEMP responses as measured by click tone and tone burst across gender in healthy young individuals. Total Sixty adult participants were taken, age range from 18-25 years (mean age 21.6 years, S.D. 1.48). Participants were divided into two groups. First group consisted of thirty male (mean age 22.1 years, S.D. 1.74) participants and second group consisted of thirty female (mean age 21.1 years, S.D. 0.96) participants. The puretone average threshold greater than 25dBHL and ‘A’ type tympanogram with presence of IPSI and CONTRA lateral acoustic reflexes within 70 dBHL was found in all the participants. Electrode placement was different for cVEMP and oVEMP testing. The cVEMP and oVEMP was recorded using 500 Hz click tone and tone burst sound stimuli in all participants. The parameters of cVEMP like peak latency (P13 and N23), amplitude, intraural amplitude difference ratio and threshold range were obtained. The oVEMP parameters of like peak latency (N13, P13 and N21), amplitude, intraural amplitude difference ratio and threshold range were obtained. For cVEMP to peak P13 to N23 amplitude and for oVEMP peak to peak P13 to N21 amplitude were taken for analysis of intra amplitude difference ratio in percentage. .The cVEMP and oVEMP responses were present in all participants. In the cVEMP responses using tone burst stimuli, the P13 peak latency for right ear (p value 0.02), amplitude for both the ears across gender (p-value of right ear <0.0001 & for left ear 0.001), and intraural difference between both the stimulus (p-value 0.0484), showed significant differences. In the oVEMP using the tone burst stimuli, the latency of N10 for right ear across the genders(p-value 0.004), and the latency of P13 for the left ear across the genders(p-value <0.000) showed significant differences which can be attributed to biological factors such as seating position, eye blinking during the test. The latency N23 of click tone cVEMP in our study was significantly different from that of one of the other studies (p-value < 0.05). The cVEMP and oVEMP responses showed no significant difference between click tone and tone burst stimuli, and the norms of different stimuli should be established for clinical interpretations. For clinical diagnosis using for cVEMP and in oVEMP, we recommend click tone and tone burst stimuli for oVEMP and tone burst for cVEMP because the latencies, amplitudes, intra amplitude difference ratio and threshold range were not significantly different for both the stimulus in oVEMP.