Validating the Utility of High Frequency Ocular Vestibular Evoked Myogenic Potential Testing in the Diagnosis of Superior Semicircular Canal Dehiscence
| Autor: | Ryan Lahey, Seilesh Babu, Robert S. Hong, Dennis I. Bojrab, Kenny F. Lin, Emily Johnson, Brent Wilkerson, Rachel Beckley |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Vestibular evoked myogenic potential Labyrinth Diseases Computed tomography Dehiscence Eye Sensitivity and Specificity Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Predictive Value of Tests Ophthalmology Chart review Temporal bone medicine Humans 030223 otorhinolaryngology Retrospective Studies Semicircular canal medicine.diagnostic_test business.industry Negative Finding Reproducibility of Results Temporal Bone Middle Aged Vestibular Evoked Myogenic Potentials Predictive value Semicircular Canals Sensory Systems medicine.anatomical_structure Otorhinolaryngology Female Vestibule Labyrinth Neurology (clinical) Tomography X-Ray Computed business 030217 neurology & neurosurgery |
| Zdroj: | Otology & Neurotology. 40:1353-1358 |
| ISSN: | 1537-4505 1531-7129 |
| Popis: | INTRODUCTION Ocular vestibular evoked myogenic potential (oVEMP) is a diagnostic test employed in the evaluation of superior semicircular canal dehiscence (SSCD) syndrome. Previous work showed that the presence of the n10 component of oVEMP at 4000 Hz was diagnostic of SSCD with perfect sensitivity and specificity of 1.0 in a series of 22 patients. This study sought to validate the diagnostic accuracy of high-frequency oVEMP with comparison to 500 Hz oVEMP and cervical vestibular evoked myogenic potential (cVEMP) in a larger series of patients. METHODS Retrospective chart review of 171 patients with clinical symptoms consistent with SSCD who underwent oVEMP and cVEMP testing. Dehiscence of the superior semicircular canal (SCC) on high-resolution computed tomography (CT) imaging of the temporal bone was used to identify cases of likely SSCD. The presence or absence of 4000 Hz oVEMP n10 responses, increased amplitude of 500 Hz oVEMP responses, and reduced threshold of 500 Hz cVEMP responses were identified for each patient. RESULTS SCC dehiscence was identified by CT imaging in 48 of 171 patients with symptoms consistent with SSCD. High-frequency oVEMP testing at 4000 Hz elicited a n10 response in 40 of 48 (83.3%) of patients and was present in 48 of 171 (28.1%) patients overall. The corresponding sensitivity was 0.83, specificity was 0.93, positive predictive value was 0.83, and negative predictive value was 0.93. oVEMP and cVEMP testing at 500 Hz was less accurate with sensitivity of 0.62 and 0.64, respectively, and specificity of 0.73 and 0.73, respectively. CONCLUSION The presence of a 4000 Hz oVEMP n10 response was predictive of SSC dehiscence on CT imaging among patients with symptoms consistent with SSCD with sensitivity of 0.83, specificity of 0.93, positive predictive value of 0.83, and negative predictive value of 0.93. A negative finding strongly rules out SSCD. High-frequency oVEMP was more accurate than 500 Hz oVEMP or cVEMP. |
| Databáze: | OpenAIRE |
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