Evaluation of Cervical Vestibular Evoked Myogenic Potentials in Conductive and Mixed Hearing Losses

cVEMP in air-bone gaps


  • Gokce TANYERI TOKER Izmir Katip Celebi University Ataturk Training and Research Hospital
  • Seval CEYLAN
  • Atilla GUMUSGUN




Cervical vestibular evoked myogenic potentials, conductive hearing loss, mixed hearing loss, air-bone gap, otosclerosis, semicircular canal dehiscence


Objective: To evaluate the role of Cervical Vestibular Evoked Myogenic Potentials (cVEMP) test in the differential diagnosis of middle and inner ear pathologies by analyzing the test results in conductive and mixed hearing loss in patients with intact tympanic membrane.

Material and Methods: The study included 50 patients (64 ears) with intact tympanic membranes and air-bone gap in pure tone audiometry test, who applied to İzmir Katip Çelebi University Atatürk Training and Research Hospital Ear, Nose and Throat Diseases polyclinic between January 2019 and September 2022. The cVEMP test results of these patients were evaluated and analyzed.

Results: The age range of the patients was 18-75, the mean age was 47.55±13.59, half of them were male and half were female. While the most common middle ear pathology was otosclerosis, inner ear pathology was superior semicircular canal dehiscence. In the other patients, pathologies such as tympanosclerosis, chronic mastoiditis, serous otitis media, ossicular chain pathology, otic capsule dehiscence, and middle ear mass were found. While no cVEMP response was obtained in 41 (82%) of the patients, cVEMP response was obtained in 9 (18%) patients.

Conclusion: The response to cVEMP test before surgery and the threshold and amplitude values determined in the test can help differential diagnosis and prevent unnecessary surgery in conductive and mixed hearing loss in patients with intact tympanic membrane.


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Martini A, Mazzoli M, Stephens D, Read AP. Definitions, protocols and guidelines in genetic hearing impairment. John Wiley & Sons Incorporated; 2001.

Scarpa A, Ralli M, Cassandro C, et al. Inner-Ear Disorders Presenting with Air-Bone Gaps: A Review. J Int Adv Otol 2020;16(1):111-6.

Colebatch JG, Halmagyi GM. Vestibular evoked potentials in human neck muscles before and after unilateral vestibular deafferentation. Neurology 1992;42:1635-6.

Colebatch JG, Halmagyi GM, Skuse NF. Myogenic potentials generated by a click-evoked vestibulocollic reflex. J Neurol Neurosurg Psychiatry 1994;57:190-7.

Halmagyi GM, Colebatch JG, Curthoys IS. New tests of vestibular function. Bailliere's Clin. Neurol 1994;3:485-500.

Bath AP, Harris N, McEwan J, Yardley MP. Effect of conductive hearing loss on the vestibulo-collic reflex. Clin Otolaryngol Allied Sci 1999;24:181-3.

Rosengren SM, Welgampola MS, Colebatch JG. Vestibular evoked myogenic potentials: past, present and future. Clin Neurophysiol 2010;121:636-51.

Göçer C, Dinç AS. Superior Semisirküler Kanal Dehissansı. KBB ve BBC Dergisi 2019;27(2):70-5.

Zhou G, Poe D, Gopen Q. Clinical use of vestibular evoked myogenic potentials in the evaluation of patients with air-bone gaps. Otol Neurotol 2012;33(8):1368-74.

Konukseven Ö, Müderris T, Müjdeci B, Gökdoğan Ç, Aksoy S. İletim tipi patolojilerde hava yolu vestibüler uyarılmış myojenik potansiyellerin ayırıcı tanıdaki rolü. JAREM. 2013;3(1):24-27.

Yang TL, Young YH. Vestibular-evoked myogenic potentials in patients with otosclerosis using air and bone conducted tone burst stimulation. Otol Neurotol 2007;28:1-6.

Minor LB, Cremer PD, Carey JP, Della Santina CC, Streubel SO, Weg N. Symptoms and signs in superior canal dehiscence syndrome. Ann N Y Acad Sci 2001;942:259-73.

Mikulec AA, McKenna MJ, Ramsey MJ, et al. Superior semicircular canal dehiscence presenting as conductive hearing loss without vertigo. Otol Neurotol 2004;25:121-9.

Minor LB. Clinical manifestations of superior semicircular canal dehiscence. Laryngoscope 2005;115(10):1717-27.

Roditi RE, Eppsteiner RW, Sauter TB, Lee DJ. Cervical vestibular evoked myogenic potentials (cVEMPs) in patients with superior canal dehiscence syndrome (SCDS). Otolaryngol Head Neck Surg 2009;141(1):24-8.

Zuniga MG, Janky KL, Nguyen KD, Welgampola MS, Carey JP. Ocular versus cervical VEMPs in the diagnosis of superior semicircular canal dehiscence syndrome. Otol Neurotol 2013;34(1):121-6.

Hunter JB, Patel NS, O’Connell BP, et al. Cervical and Ocular VEMP Testing in Diagnosing Superior Semicircular Canal Dehiscence. Otolaryngology-Head and Neck Surgery 2017;156(5):917-23.




How to Cite

TANYERI TOKER, G., CEYLAN, S., & GUMUSGUN, A. (2023). Evaluation of Cervical Vestibular Evoked Myogenic Potentials in Conductive and Mixed Hearing Losses: cVEMP in air-bone gaps. Chronicles of Precision Medical Researchers, 4(1), 1–6. https://doi.org/10.5281/zenodo.7718946