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Vol. 69. Issue 3.
Pages 141-148 (May - June 2018)
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Vol. 69. Issue 3.
Pages 141-148 (May - June 2018)
Original article
DOI: 10.1016/j.otoeng.2017.06.016
oVEMP as an objective indicator of successful repositioning maneuver
Potencial miogèc)nico evocado vestibular ocular (oVEMP) como indicador objetivo de las maniobras de reposicionamiento exitoso en el vèc)rtigo posicional paroxístico benigno
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Samir Asal, Osama Sobhy, Amany Balbaa
Corresponding author
amany.balbaa@hotmail.com

Corresponding author.
Audiology Department, Alexandria Faculty of Medicine, Alexandria, Egypt
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Tables (4)
Table 1. Comparison between unaffected ear and affected ear according to PTA average.
Table 2. Comparison between unaffected ears and ears with BPPV at different periods according to N1 latency.
Table 3. Comparison between unaffected ears and ears with BPPV at different periods according to P1 latency.
Table 4. Comparison between the different periods according to N1•P1 amplitude.
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Abstract
Background and objective

Benign paroxysmal positioning vertigo (BPPV) is the most common peripheral vestibular disorder. Canalolithiasis in the posterior semi-circular canal is the most common underlying pathology that can be treated effectively by repositioning maneuvers. Our hypothesis suggested that successful maneuvers can lead to repositioning of dislodged otoconia to the utricle.

Materials and methods

Air conducted oVEMP, which is thought to originate from the contra-lateral utricular organ was measured in twenty patients with unilateral BPPV and we compared n1•p1 peak to peak amplitude of the affected ears in 3 separate intervals: on pre-treatment when typical nystagmus was confirmed, immediately after, and 1 week after repositioning maneuvers to assess change, if any, in amplitude.

Results

This study showed significant increase of oVEMP amplitude in the affected ears after successful repositioning maneuver that was more significant after 1 week.

Conclusions

oVEMP can be used as a reliable objective test for ensuring a successful maneuver rather than subjective dependence on the patient's symptoms, which may be misleading due to a remission.

Keywords:
Ocular vestibular evoked myogenic potential
Benign paroxysmal positioning vertigo
Repositioning maneuvers
Resumen
Antecedentes y objetivo

El vèc)rtigo posicional paroxístico benigno es el trastorno vestibular perifèc)rico más común. La canalolitiasis en el canal semicircular posterior es la enfermedad subyacente más común, que puede tratarse eficazmente mediante maniobras de reposicionamiento. Nuestra hipótesis sugiere que las maniobras exitosas pueden originar un reposicionamiento de la otoconia desplazada hacia el utrículo.

Materiales y mèc)todos

El potencial miogèc)nico evocado vestibular ocular (oVEMP) con conducción de aire, cuyo origen se piensa que se halla en el utrículo contralateral, se midió en 20 pacientes con vèc)rtigo posicional paroxístico benigno unilateral comparando la amplitud n1-p1 de pico a pico de los oídos afectados en 3 intervalos separados: previamente al tratamiento cuando se confirmó el nistagmo típico, inmediatamente despuèc)s y transcurrida una semana de las maniobras de reposicionamiento, para confirmar el cambio de amplitud, de haberse producido.

Resultados

Este estudio reflejó un incremento considerable de la amplitud del oVEMP en los oídos afectados, tras las maniobras exitosas de reposicionamiento, que fue más significativa trascurrida una semana.

Conclusiones

El oVEMP puede utilizarse como prueba objetiva fiable para garantizar una maniobra exitosa, en lugar de la dependencia subjetiva de la sintomatología del paciente, que puede resultar engañosa debido a su remisión.

Palabras clave:
Potencial miogèc)nico evocado vestibular ocular
Vèc)rtigo posicional paroxístico benigno
Maniobras de reposicionamiento

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