Effect of conductive hearing loss on the vestibulo-collic reflex

Abstract

The vestibulo-collic reflex represents a promising test for evaluating the integrity of otolith function. We have investigated the threshold of this response in a group of normal subjects, and the effect of a conductive hearing loss. A positive response was recorded in 31 of 32 normal subjects. The threshold of the vestibulo-collic reflex varied from 80 to 97 dBHL in these subjects with a 95% response rate at a threshold at 96 dBHL. A total of 23 ears with a conductive hearing loss in 17 patients were also investigated. The average conductive hearing loss (at 0.5, 1, 2 and 4 kHz) ranged from 8.75 to 40 dBHL (average 24.46 dBHL). A positive response was recorded in only two ears. Therefore, the vestibulo-collic reflex has a high stimulus threshold which is dependant on reliable transmission of the click stimulus to the inner ear thus limiting is clinical use.

Novel subtype of idiopathic bilateral vestibulopathy: bilateral absence of vestibular evoked myogenic potentials in the presence of normal caloric responses

“…The following were the exclusion criteria: (1) medical history of other neurological disorders, (2) familial history of auditory or vestibular dysfunction, (3) past history of excessive noise exposure, head injury or exposure to ototoxic drugs, (4) sensorineural hearing loss except for presbycusis, (5) the existence of air-bone gap (more than 10 dB) [8], (6) abnormal findings on neurological examinations except for vestibular dysfunction, (7) difficulty in maintaining muscle activity at a sufficient level [electromyographic (EMG) activity [150 lV].…”

Single motor unit responses underlying cervical vestibular evoked myogenic potentials produced by bone-conducted stimuli

“…cVEMPs are not dependent upon hearing and are therefore present in patients with sensorineural hearing loss. However, they are attenuated or absent in patients with conductive hearing loss, as the air-conducted stimulus requires efficient transfer through the outer and middle ear to the vestibule (Bath et al, 1999). To overcome this disadvantage of air-conducted sound, Halmagyi et al (1995) demonstrated that cVEMPs could also be elicited by tapping the forehead with a clinical reflex hammer.…”

Vestibular neuritis in a child with otitis media with effusion; clinical application of vestibular evoked myogenic potential by bone-conducted sound

“…To record VEMP, airconducted sound is usually applied. Then, the integrity of the middle ear conductive mechanism [5,8] is required. It is often difficult to elicit this vestibulardependent response in subjects with conductive hearing loss.…”