Air- and bone-conducted Vestibular Evoked Myogenic Potentials (VEMPs) in otosclerosis: recordings before and after stapes surgery

Aim of the study was to investigate, in a randomized prospective trial, air-conducted vestibular evoked myogenic potentials (AC-VEMPs) and bone-conducted vestibular evoked myogenic potentials (BC-VEMPs) before and after successful stapedotomy. Enrolled in the study were 41 consecutive patients (32 female, 9 male; mean age 36 years) (42 ears) with otosclerosis. Audiological evaluations and diagnosis of otosclerosis were made according to the guidelines of the Committee on Hearing and Equilibrium. Successful stapedotomy was carried out in all otosclerotic ears. Air- and bone-conducted 4-frequency pure tone average (4-PTA), air-bone gap (ABG), AC- and BC-VEMPs were evaluated pre- and post-operatively. As far as concerns results, pre-operatively, AC- and BC-VEMPs could be recorded in 9 (21.4%) and 16 (38.1%) otosclerotic ears, respectively. Lower ABG was detected in patients with AC-VEMPs in comparison to those in whom air-conducted potentials (p = 0.032) could not be elicited. At 12-month post-operative follow-up, AC-VEMPs were present in 11 (26.2%) ears, while BC-VEMPs could be elicited in 15 (35.7%) cases. Reduced bone-conduction 4-PTA was observed in patients with BC-VEMPs in comparison to those without recordable bone-conducted potentials pre- and post-operatively (p = 0.003 and p = 0.005, respectively). A significantly (p = 0.022) lower air-conducted 4-PTA was measured post-stapedotomy in patients with BC-VEMPs in comparison to those without elicitable bone-conducted potentials. In conclusion, VEMPs reduced elicitability, in otosclerosis, is likely due to conductive hearing loss and inner ear impairment.