Value of vestibular evoked myogenic potentials and electrocochleography in predicting the prognosis of acute low-frequency sensorineural hearing loss

Abstract:

Objective To investigate the value of vestibular evoked myogenic potentials（VEMPs） and electrocochleography（EcochG） in predicting the prognosis of acute low-frequency sensorineural hearing loss（ALFHL）.Methods Medical records were collected from 60 patients with first-time unilateral ALFHL who were hospitalized in Department of Otolaryngology，The First Affiliated Hospital of Chongqing Medical University from January 2020 to June 2022. All patients underwent the examinations of EcochG，ocular vestibular evoked myogenic potentials（oVEMP），and cervical vestibular evoked myogenic potentials（cVEMP） after admission，and pure tone audiometry was performed before treatment and at 1 week，2 weeks，and 1 month after treatment. An EcochG SP/AP ratio of >0.4 and an SP/AP area ratio of >1.92 were considered abnormal. If cVEMP and oVEMP were not elicited or if the amplitude ratio was ≤1.61 and the asymmetry ratio was ≤0.29，it was considered abnormal. The chi-square test，the McNemar test，and the Mann-Whitney test were used for comparison of rates between groups，and univariate and multivariate binary logistic regression analyses were used to identify the risk factors for the prognosis of ALFHL.Results The abnormal rates of EcochG，cVEMP，and oVEMP were 26.7%，23.3%，and 35.0%，respectively，in the 60 patients with ALFHL. The abnormal rates of EcochG and oVEMP showed no correlation with age，sex，hearing loss level，starting time of treatment，aural fullness，and dizziness. The abnormal rate of cVEMP in the ALFHL patients with hearing loss >40 dB HL was significantly higher than that in the patients with hearing loss ≤40 dB HL（P<0.05）. The patients with abnormal EcochG，cVEMP，and oVEMP had a significantly lower degree of hearing improvement than those with normal results（P<0.05）. The univariate binary logistic regression analysis showed that abnormal EcochG，cVEMP，and oVEMP were risk factors for non-recovery of ALFHL（all P<0.05），while the multivariate binary logistic regression analysis showed that cVEMP and oVEMP were independent risk factors for non-recovery of ALFHL（both P<0.05）.Conclusion Abnormal cVEMP and oVEMP are independent risk factors for non-recovery of ALFHL，which may be associated with the difficulty in the regression of hydrops in the saccule and utricle of ALFHL patients. The detection of abnormal cVEMP and oVEMP indicates a high risk of non-recovery in patients with ALFHL.