The Pre- and Poststapedectomy VEMPs Findings in Clinical Otosclerosis

Background and Aim: Otosclerosis is an inherited and progressive disease with an abnormal spongelike bone growth in the middle ear. This abnormal growth interferes with stapes motion and results in conductive hearing loss, usually correctable by surgery (stapedectomy). Vestibular-evoked myogenic potentials (VEMPs) is a new method for evaluating the status of the vestibular system and, more precisely, of the saccule. The aim of the present study was to investigate whether VEMPs correlates with the saccular function in patients with otosclerosis. Material and Methods: We assessed 22 patients (8 men and 14 women; age range, 23–62 years; mean age, 44.5 years) with otosclerosis in 38 ears before and after stapedectomy. Air-conducted (AC) and bone-conducted (BC) tone-burst-evoked VEMPs were measured preoperatively and 3 months after stapedectomy. In addition, otoscopic examinations, tuning fork tests, pure tone audiometry (PTA), and impedance audiometry were conducted. Results: In the 38 otosclerotic ears, 3 ears (8%) showed present AC VEMPs, and 15 ears (39%) displayed present BC VEMPs. The mean preoperative air-bone gap (ABG) in those ears with present AC or BC- VEMPs was within 25 dB HL. In 11 ears presented postoperatively within the first 3 months, AC VEMPs were found in 4 ears (36%), BC VEMPs in 9 ears (81%). In 4 ears (36%) in which VEMPs were absent, reappeared after surgery (mean postoperative ABG ≤11 dB HL). Conclusions: The reduction of the ABG after stapedectomy seems to improve the elicitability of VEMPs, in some cases.