2025 Volume 84 Issue 3 Pages 128-134
Vestibular Evoked Myogenic Potential (VEMP) is used as an otolithic function test, with characteristic findings reported in various inner ear disorders and age-related effects. In Meniere’s disease, the optimal frequency is believed to shift from 500 Hz to 1000 Hz due to the presence of endolymphatic hydrops. This frequency shift is also observed in elderly individuals. In a study where cVEMP was measured at both 500 Hz and 1000 Hz, we investigated the disease-specific characteristics of frequency responses and the effects of aging. The subjects were 175 cases (ages 10–97 years; mean age 55.0 years). The results of cVEMP testing were determined using the corrected amplitude (CA) and asymmetry ratio (AR) at 500 Hz. Frequency characteristics were evaluated using the 500–1000 Hz slope.
Presbyvestibulopathy (PVP) and otolithic dysfunctions were more prevalent in older individuals, with abnormal cVEMP findings in all cases. The rate of failure and positive findings based on slope evaluation were significantly higher in older age groups. The slope positivity rate was higher in sudden deafness (SD) than that in Meniere’s disease (MD). As a test for endolymphatic hydrops, the tuning property test using the slope could yield false-positives in elderly individuals, and caution is required when diagnosing MD.
The tuning property test may serve as a parameter for distinguishing SD from MD and suggesting a transition to Delayed endolymphatic hydrops (DEH). Additionally, combining this with other tests like vHIT may help in elucidating the pathophysiology of SD.
