Air-Conducted Vestibular Evoked Myogenic Potential Testing in Children, Adolescents, and Young Adults: Thresholds, Frequency Tuning, and Effects of Sound Exposure

Abstract

Children, adolescents, and young adults show VEMP thresholds below high stimulation levels and had similar frequency tuning between 500 and 750 Hz. Use of 750 Hz could be regarded as the safer stimuli due to its shorter duration and thus reduced sound exposure. Children with smaller ear-canal volume had present responses at maximum stimulation and lower thresholds, suggesting that VEMP testing could be initiated at lower acoustic levels to minimize sound exposure and optimize testing.

Vestibular evoked myogenic potentials in practice: Methods, pitfalls and clinical applications

“…3) (Park et al, 2010, Rosengren et al, 2011, Rodriguez et al, 2019). The consequence of this is that AC oVEMPs are more often absent than cVEMPs and are particularly sensitive to the effects of age (Piker et al, 2011, Piker et al, 2013, Piker et al, 2015, Rosengren et al, 2011, Singh and Firdose, 2018).…”

Quantitative Vestibular Function Testing in the Pediatric Population

“…24 In children, normative cVEMP threshold responses have been reported at approximately 105 to 110 dB SPL, 26,28 which is consistent with data from our laboratory. 29 Most often cVEMPs are considered abnormal if responses are absent or low in amplitude; however, with third window disorders, such as enlarged vestibular aqueduct or superior canal dehiscence, large amplitudes and low thresholds are considered abnormal. 30,31 cVEMP responses in a child with bilateral enlarged vestibular aqueduct are shown in Fig.…”

“…27,35,36 For children, oVEMP thresholds are approximately 110 to 115 dB SPL and similar to that of young adults, 38 which is consistent with findings from our laboratory. 29 Similar to cVEMP, oVEMPs are considered abnormal if responses are absent or low in amplitude; however, with third window disorders, large amplitudes and low thresholds are considered abnormal. oVEMP responses in a child with bilateral enlarged vestibular aqueduct are shown in Fig.…”

“…Second, children have similar cVEMP and oVEMP responses at both 500 and 750 Hz, suggesting similar frequency tuning. 29 Therefore, a 750-Hz tone burst stimulus can be used, which has a shorter duration and subsequently less sound exposure than the traditionally used 500-Hz tone burst. Third, when performing VEMP threshold testing in children, testing can be achieved without affecting cochlear function by using an ascending approach.…”

“…Third, when performing VEMP threshold testing in children, testing can be achieved without affecting cochlear function by using an ascending approach. 29 Lastly, because cVEMP and oVEMP threshold values are noted below standard high-intensity levels (i.e., 125 dB SPL) in children, testing can be initiated at an even lower level (115 or 110 dB SPL) if several repetitions are necessary.…”