Cervical and Ocular VEMP Testing in Diagnosing Superior Semicircular Canal Dehiscence

Jacob B. Hunter, Neil S. Patel, Brendan P. O’Connell, Matthew L. Carlson, Neil T. Shepard, Devin L. McCaslin, George B. Wanna

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objective: To determine the sensitivity and specificity of ocular and cervical vestibular evoked myogenic potentials (VEMPs) in the diagnosis of superior semicircular canal dehiscence (SCD) and to describe the VEMP response characteristics that are most sensitive to SCD and compare the findings to previous reports. Study Design: Case series with chart review. Setting: Two tertiary neurotologic referral centers. Subjects and Methods: Cervical and ocular VEMP peak-to-peak amplitudes and thresholds from 39 adult patients older than 18 years with surgically confirmed SCD were compared with 84 age-matched controls. Results: Using receiver operating characteristic (ROC) curves, cervical VEMP (cVEMP) amplitudes, cVEMP thresholds, and ocular VEMP (oVEMP) amplitudes had areas under the curve of 0.731, 0.912, and 0.856, respectively, all of which were statistically significant (P <.0001). For cVEMP thresholds, at the clinical equivalent ≤85-dB normalized hearing level (nHL) threshold, the sensitivity and specificity were 97.3% and 31.3%, respectively. At the ≤70-dB nHL threshold, the sensitivity and specificity were 73.0% and 94.0%, respectively. For oVEMP amplitudes >12.0 µV, the sensitivity and specificity were 78.6% and 81.7%, respectively. Conclusion: Data from this multicenter study suggest that both cVEMP thresholds and oVEMP amplitudes remain good diagnostic tests for identifying SCD, with each test dependent on a number of factors. The sensitivity and specificity of these individual tests may vary slightly between centers depending on testing parameters used.

Original languageEnglish (US)
Pages (from-to)917-923
Number of pages7
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume156
Issue number5
DOIs
StatePublished - May 1 2017

Fingerprint

Vestibular Evoked Myogenic Potentials
Semicircular Canals
Sensitivity and Specificity
Routine Diagnostic Tests
Tertiary Care Centers
ROC Curve
Multicenter Studies
Area Under Curve

Keywords

  • cranial base
  • neurotology
  • skull base
  • superior semicircular canal dehiscence
  • VEMP
  • vestibular

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Hunter, J. B., Patel, N. S., O’Connell, B. P., Carlson, M. L., Shepard, N. T., McCaslin, D. L., & Wanna, G. B. (2017). Cervical and Ocular VEMP Testing in Diagnosing Superior Semicircular Canal Dehiscence. Otolaryngology - Head and Neck Surgery (United States), 156(5), 917-923. https://doi.org/10.1177/0194599817690720

Cervical and Ocular VEMP Testing in Diagnosing Superior Semicircular Canal Dehiscence. / Hunter, Jacob B.; Patel, Neil S.; O’Connell, Brendan P.; Carlson, Matthew L.; Shepard, Neil T.; McCaslin, Devin L.; Wanna, George B.

In: Otolaryngology - Head and Neck Surgery (United States), Vol. 156, No. 5, 01.05.2017, p. 917-923.

Research output: Contribution to journalArticle

Hunter, Jacob B. ; Patel, Neil S. ; O’Connell, Brendan P. ; Carlson, Matthew L. ; Shepard, Neil T. ; McCaslin, Devin L. ; Wanna, George B. / Cervical and Ocular VEMP Testing in Diagnosing Superior Semicircular Canal Dehiscence. In: Otolaryngology - Head and Neck Surgery (United States). 2017 ; Vol. 156, No. 5. pp. 917-923.
@article{374a85f29921453e9406b79707936ffb,
title = "Cervical and Ocular VEMP Testing in Diagnosing Superior Semicircular Canal Dehiscence",
abstract = "Objective: To determine the sensitivity and specificity of ocular and cervical vestibular evoked myogenic potentials (VEMPs) in the diagnosis of superior semicircular canal dehiscence (SCD) and to describe the VEMP response characteristics that are most sensitive to SCD and compare the findings to previous reports. Study Design: Case series with chart review. Setting: Two tertiary neurotologic referral centers. Subjects and Methods: Cervical and ocular VEMP peak-to-peak amplitudes and thresholds from 39 adult patients older than 18 years with surgically confirmed SCD were compared with 84 age-matched controls. Results: Using receiver operating characteristic (ROC) curves, cervical VEMP (cVEMP) amplitudes, cVEMP thresholds, and ocular VEMP (oVEMP) amplitudes had areas under the curve of 0.731, 0.912, and 0.856, respectively, all of which were statistically significant (P <.0001). For cVEMP thresholds, at the clinical equivalent ≤85-dB normalized hearing level (nHL) threshold, the sensitivity and specificity were 97.3{\%} and 31.3{\%}, respectively. At the ≤70-dB nHL threshold, the sensitivity and specificity were 73.0{\%} and 94.0{\%}, respectively. For oVEMP amplitudes >12.0 µV, the sensitivity and specificity were 78.6{\%} and 81.7{\%}, respectively. Conclusion: Data from this multicenter study suggest that both cVEMP thresholds and oVEMP amplitudes remain good diagnostic tests for identifying SCD, with each test dependent on a number of factors. The sensitivity and specificity of these individual tests may vary slightly between centers depending on testing parameters used.",
keywords = "cranial base, neurotology, skull base, superior semicircular canal dehiscence, VEMP, vestibular",
author = "Hunter, {Jacob B.} and Patel, {Neil S.} and O’Connell, {Brendan P.} and Carlson, {Matthew L.} and Shepard, {Neil T.} and McCaslin, {Devin L.} and Wanna, {George B.}",
year = "2017",
month = "5",
day = "1",
doi = "10.1177/0194599817690720",
language = "English (US)",
volume = "156",
pages = "917--923",
journal = "Otolaryngology - Head and Neck Surgery (United States)",
issn = "0194-5998",
publisher = "Mosby Inc.",
number = "5",

}

TY - JOUR

T1 - Cervical and Ocular VEMP Testing in Diagnosing Superior Semicircular Canal Dehiscence

AU - Hunter, Jacob B.

AU - Patel, Neil S.

AU - O’Connell, Brendan P.

AU - Carlson, Matthew L.

AU - Shepard, Neil T.

AU - McCaslin, Devin L.

AU - Wanna, George B.

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Objective: To determine the sensitivity and specificity of ocular and cervical vestibular evoked myogenic potentials (VEMPs) in the diagnosis of superior semicircular canal dehiscence (SCD) and to describe the VEMP response characteristics that are most sensitive to SCD and compare the findings to previous reports. Study Design: Case series with chart review. Setting: Two tertiary neurotologic referral centers. Subjects and Methods: Cervical and ocular VEMP peak-to-peak amplitudes and thresholds from 39 adult patients older than 18 years with surgically confirmed SCD were compared with 84 age-matched controls. Results: Using receiver operating characteristic (ROC) curves, cervical VEMP (cVEMP) amplitudes, cVEMP thresholds, and ocular VEMP (oVEMP) amplitudes had areas under the curve of 0.731, 0.912, and 0.856, respectively, all of which were statistically significant (P <.0001). For cVEMP thresholds, at the clinical equivalent ≤85-dB normalized hearing level (nHL) threshold, the sensitivity and specificity were 97.3% and 31.3%, respectively. At the ≤70-dB nHL threshold, the sensitivity and specificity were 73.0% and 94.0%, respectively. For oVEMP amplitudes >12.0 µV, the sensitivity and specificity were 78.6% and 81.7%, respectively. Conclusion: Data from this multicenter study suggest that both cVEMP thresholds and oVEMP amplitudes remain good diagnostic tests for identifying SCD, with each test dependent on a number of factors. The sensitivity and specificity of these individual tests may vary slightly between centers depending on testing parameters used.

AB - Objective: To determine the sensitivity and specificity of ocular and cervical vestibular evoked myogenic potentials (VEMPs) in the diagnosis of superior semicircular canal dehiscence (SCD) and to describe the VEMP response characteristics that are most sensitive to SCD and compare the findings to previous reports. Study Design: Case series with chart review. Setting: Two tertiary neurotologic referral centers. Subjects and Methods: Cervical and ocular VEMP peak-to-peak amplitudes and thresholds from 39 adult patients older than 18 years with surgically confirmed SCD were compared with 84 age-matched controls. Results: Using receiver operating characteristic (ROC) curves, cervical VEMP (cVEMP) amplitudes, cVEMP thresholds, and ocular VEMP (oVEMP) amplitudes had areas under the curve of 0.731, 0.912, and 0.856, respectively, all of which were statistically significant (P <.0001). For cVEMP thresholds, at the clinical equivalent ≤85-dB normalized hearing level (nHL) threshold, the sensitivity and specificity were 97.3% and 31.3%, respectively. At the ≤70-dB nHL threshold, the sensitivity and specificity were 73.0% and 94.0%, respectively. For oVEMP amplitudes >12.0 µV, the sensitivity and specificity were 78.6% and 81.7%, respectively. Conclusion: Data from this multicenter study suggest that both cVEMP thresholds and oVEMP amplitudes remain good diagnostic tests for identifying SCD, with each test dependent on a number of factors. The sensitivity and specificity of these individual tests may vary slightly between centers depending on testing parameters used.

KW - cranial base

KW - neurotology

KW - skull base

KW - superior semicircular canal dehiscence

KW - VEMP

KW - vestibular

UR - http://www.scopus.com/inward/record.url?scp=85018795688&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85018795688&partnerID=8YFLogxK

U2 - 10.1177/0194599817690720

DO - 10.1177/0194599817690720

M3 - Article

C2 - 28168887

AN - SCOPUS:85018795688

VL - 156

SP - 917

EP - 923

JO - Otolaryngology - Head and Neck Surgery (United States)

JF - Otolaryngology - Head and Neck Surgery (United States)

SN - 0194-5998

IS - 5

ER -