Saccular function in otosclerosis patients: bone conducted-vestibular evoked myogenic potential analysis

Vestibular involvements have long been observed in otosclerotic patients. Among vestibular structures saccule has the closest anatomical proximity to the sclerotic foci, so it is the most prone vestibular structure to be affected during the otosclerosis process. The aim of this study was to investigate the saccular function in patients suffering from otosclerosis, by means of Vestibular Evoked Myogenic Potential [VEMP]. The material consisted of 30 otosclerosis patients and 20 control subjects. All participants underwent audiometric and VEMP testing. Analysis of tests results revealed that the mean values of Air-Conducted Pure Tone Average [AC-PTA] and Bone-Conducted Pure Tone Average [BC-PTA] in patients were 45.28 +/- 15.57 and 19.68 +/- 10.91, respectively and calculated 4 frequencies Air Bone Gap [ABG] was 25.64 +/- 9.95. The VEMP response was absent in 14 [28.57%] otosclerotic ears. A statistically significant increase in latency of the p13 was found in the affected ears [P=0.004], differences in n23 latency did not reach a statistically significant level [P=0.112]. Disparities in amplitude of p13-n23 in between two study groups was statistically meaningful [P=0.009], indicating that the patients with otosclerosis had lower amplitudes. This study tends to suggest that due to the direct biotoxic effect of the materials released from the otosclerosis foci on saccular receptors, there might be a possibility of vestibular dysfunction in otosclerotic patients