Development and Validation of a Questionnaire to Assess the Effect of Vestibular Rehabilitation Therapy.

Vestibular rehabilitation therapy (VRT) is an effective treatment for individuals experiencing imbalance and dizziness, helps to improve the quality of life. Lack of culturally valid questionnaires to assess the outcome from VRT necessitates the development of reliable and culturally valid questionnaire to measure the outcomes of VRT. Hence, the current study aimed to develop a culturally valid and reliable questionnaire for measuring the outcome of VRT in Indian population and to translate it into Malayalam and Kannada. This cross-sectional study was conducted at the department of Audiology and Speech Language Pathology of a tertiary care hospital. The questionnaire was constructed based on thorough literature search of existing questionnaires related to dizziness and vestibular disorders in relevant to the Indian context. Content validity was assessed by expert reviewers using a rating scale, and the questionnaire was translated into two south Indian languages (Malayalam and Kannada). The questionnaire was then administered on 12 patients undergoing VRT to assess its initial validation. The questionnaire was named as 'Effect of Vestibular Rehabilitation Therapy Questionnaire (EVRT-Q)', consisted of 25 questions divided into three domains: symptom, function, and emotion. The questionnaire demonstrated good content validity with a Content Validity Index greater than 0.8 for each question in all domains. The questionnaire possesses a high internal consistency when measured using Cronbach's alpha. Hence, the EVRT-Q appears to be a valid and reliable tool to assess the outcome from VRT in Indian population.

The Effect of Hemodialysis on Spectral and Temporal Processing Abilities and Speech Perception in Noise among Individuals with Chronic Kidney Disease.

INTRODUCTION: The effect of chronic kidney disease (CKD) on hearing is well documented in the literature. Several studies have investigated the effect of hemodialysis on the peripheral auditory system among individuals with CKD. However, studies investigating the effect of hemodialysis on speech perception and auditory processing abilities are limited. The present study investigated the effect of hemodialysis on few auditory processing abilities and speech perception in noise among adults with CKD. METHODS: A total of 25 adults with CKD undergoing hemodialysis regularly participated in the study. Spectral ripple discrimination threshold (SRDT), gap detection threshold (GDT), amplitude-modulation detection threshold (AMDT), and speech recognition threshold in noise (SRTn) were measured before and after hemodialysis. Paired samples "t" test was carried out to investigate the effect of hemodialysis on thresholds. RESULTS: Results showed a significant improvement for SRDT, GDT, AMDT, and SRTn after hemodialysis among individuals with CKD. DISCUSSION: Hemodialysis showed a positive effect on speech perception in noise and auditory processing abilities among individuals with CKD.

Ovarian hydatid cyst: an uncommon site of presentation.

Hydatid cyst is a parasitic infestation caused by Echinococcus larvae. Hydatid cyst of the ovary is a highly unusual presentation. Herein, we present a case of a young woman who complained of episodic lower abdominal pain. Ultrasound of the abdomen revealed a multi-cystic left adnexal mass measuring 86 mm x 67 mm. A possibility of ovarian cystic neoplasm was suggested. Unilateral salpingo-oophorectomy was performed. On histopathological examination, a cyst measuring 8.0 x 5.5 x 4.5 cm was found, replacing the entire ovary. The cyst cavity was filled with serous fluid and multiple pearly white membranous structures, giving a multiloculated appearance. Microscopic examination showed a cyst lined by a lamellar membrane containing protoscolices and hooklets. Hydatid disease is a zoonotic ailment caused by tapeworms (Echinococcus granulosus or, less commonly, Echinococcus multilocularis). The definitive hosts are carnivores. Humans are the accidental intermediate hosts. The hydatid cyst commonly affects the liver and the lungs. The primary hydatid cyst of the ovary is quite rare, with few case reports in the literature. In most cases, symptoms are vague, and the lesion is misdiagnosed as benign or malignant ovarian cystic neoplasm on clinical and radiological examination. Ovarian hydatid cyst is treated by surgery with ovarian cystectomy as the gold standard. The possibility of a hydatid cyst should be kept under differential diagnoses while evaluating the cystic diseases of the ovary.

Covalently bonded interface in polymer/boron nitride nanosheet composite toward enhanced mechanical and thermal behaviour.

This experimental study aimed to enhance the mechanical and thermal properties of BN (hexagonal boron nitride) nanosheet-reinforced high-density polyethylene by functionalizing its interface. The challenges associated with this nanocomposites are its poor dispersion and weak interface. Accordingly, to improve the load transfer at the interface, BN nanosheets were chemically modified with silane functional groups ((3-aminopropyl)tri-ethoxy silane), making it possible to form covalent bonds between the maleic anhydride-grafted polyethylene and nanosheet. Consequently, three different types of nanocomposite samples were fabricated based on the covalently bonded or non-bonded interface. Two nanocomposite configurations featured a non-bonded interface between the nanofiller and PE matrix (p-BN/PE and (silane functionalized) s-BN/PE). In contrast, the third configuration had a covalently bonded interface (silane-functionalized h-BN + maleic anhydride-grafted PE, i.e., PE-g-BN). According to the zeta potential analysis, the silane-functionalized BN nanosheets were stable suspensions and uniformly dispersed in the polymer matrix. The tensile and flexure strength of the nanocomposites showed over 100% improvement due to the covalently bonded interface. The lamellae structure of PE in the bonded interface samples was responsible for achieving higher mechanical strength in the nanocomposites. Furthermore, the thermal conductivity of the nanocomposites was significantly affected by the type of interfacial bonding, BN wt%, and operating temperature.

An Exploratory Study of Cervical Vestibular-Evoked Myogenic Potential in Users of Personal Listening Devices.

Context: The use of personal listening devices (PLDs) is becoming increasingly popular, particularly among young people. Numerous studies have demonstrated that being exposed to PLDs can have adverse effects on the auditory system. Owing to the similarities between the auditory and vestibular systems, it is possible that the negative effects of PLD use may extend to the vestibular system, an area that has not been extensively studied. Aim: The study aimed to investigate the impact of exposure to PLDs on the vestibular system, specifically the sacculo-collic reflex assessed by the cervical vestibular-evoked myogenic potential. Settings and Design: The current study used a cross-sectional study design. Materials and Methods: A total of 80 participants were divided into four groups based on the history of PLD exposure. Each group consisted of 20 participants who underwent cervical vestibular-evoked myogenic potential (cVEMP) testing using alternating polarity 500 Hz tone bursts. Statistical Analysis Used: Analysis of variance (ANOVA) and Bonferroni post hoc test were used to obtain the statistically significant difference among the group. Results: The results showed that the amplitude of p1-n1 of cVEMP was significantly reduced in individuals with longer PLD exposure duration. Conclusion: The study suggests that listening to music through a PLD at high levels of volume controls could be deleterious to the vestibular well-being of an individual. The study highlights the importance of being aware of the adverse effects of using PLDs to prevent potential damage to the vestibular systems.

Primary malignant melanoma of the gall bladder masquerading as xanthogranulomatous cholecystitis.

Malignant melanoma of the gall bladder is rare. Most cases are metastatic and primary gall bladder melanoma is even more rare. We report a case of primary malignant melanoma of the gall bladder which illustrates the diagnostic challenge posed by this condition. Histopathology and immunohistochemistry play a pivotal role in making a diagnosis and ruling out conditions which mimic it such as xanthogranulomatous cholecystitis and other relatively common epithelial malignancies. We tested for prognostic and predictive markers including BRAF and PD-L1 and immunohistochemistry showed positive staining for BRAF. The tumour cells expressed HMB-45 and were negative for cytokeratin and CD68, favouring a diagnosis of malignant melanoma and excluding the possibility of xanthogranulomatous cholecystitis and carcinoma. On follow-up at 3 months there was no evidence of recurrence of metastasis.

Cervical Vestibular-Evoked Myogenic Potentials in Individuals with Diabetes Mellitus: A Systematic Review and Meta-Analysis.

Vestibular evoked myogenic potentials (VEMPs) in individuals with diabetes mellitus (DM) provide evidence as how diabetes can bring about changes in the peripheral nervous system. Cervical VEMP (cVEMP) evaluates the function and integrity of the sacullo- collic pathway and ocular VEMP (oVEMP) evaluates the utriculo-collic pathway. cVEMP is an ipsilateral inhibitory response of the sternocleidomastoid muscle. cVEMP is recorded at higher intensity above 80-85 dBnHL with biphasic waveforms having initial peak positivity P13 followed by a negativity N23. We performed a systematic review following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to evaluate cVEMP in diabetes mellitus. The search was conducted in the databases: PubMed, Cumulative Index of Nursing and Allied Health Literature, Scopus, and Cochrane library using the keywords "diabetes mellitus" and "vestibular evoked myogenic potential" or "cVEMP." A two-phase selection process was used for the final inclusion of studies, and the methodological quality of these studies was assessed using the Newcastle Ottawa scale (NCOS). Meta-analysis was performed using a random-effects model. For comparisons between DM and healthy controls, a significant difference was observed for cVEMP amplitude (P = 0.01). Our meta-analysis's results suggest peripheral vestibular dysfunction can be observed in DM. It appears that cVEMPs may be useful in the early detection of neuropathy in DM.

Interventional Study of Flunarizine Therapy on Symptom Relief and Vestibular Evoked Myogenic Potential Changes in Individuals with Vestibular Migraine.

INTRODUCTION: Migraine is the third most common disease in the world with an estimated prevalence of 14.7%. The purpose of this study was to identify the characteristic changes in cervical and ocular vestibular evoked myogenic potential (VEMP) and analyse changes in symptoms and VEMP after flunarizine therapy in patients diagnosed with vestibular migraine (VM). METHODS: Prospective interventional study was conducted on 31 VM patients. Cervical VEMP (cVEMP) and ocular VEMP (oVEMP) were recorded. Flunarizine (10 mg) was given once daily for two consecutive months. Prophylactic therapy was monitored with a monthly follow-up assessment of their symptoms and VEMP was repeated after 2 months. RESULTS: Headache was the chief complaint (67.7%). Vertigo was spontaneous and mostly moderate in intensity (93%). cVEMP was absent in 1 patient and oVEMP was absent in 3 patients. Post prophylactic treatment with flunarizine, there was significant reduction in the frequency (p = 0.001) and duration (p = 0.001) of headache and frequency (p = 0.001), duration (p = 0.001), and intensity (p = 0.009) of vertigo. cVEMP and oVEMP showed no significant differences (p > 0.05) between pre- and post-treatment recordings. CONCLUSION: Treatment with flunarizine helps in considerably reducing the episodes and duration of headache, as well as episodes, duration, and intensity of vertigo.

Evaluation of outcome of acoustic reflex tests in patients with type 2 diabetes mellitus: a cross-sectional study.

PURPOSE: Type 2 diabetes mellitus (T2DM) may induce micro-vascular and macro-vascular changes that can lead to neuropathic changes which may affect the auditory pathway resulting in hearing loss. The study aims to evaluate the outcome of ipsilateral and contralateral acoustic reflex (AR) parameters and reflex decay tests (RDT) in patients with T2DM, and the relationship between average AR parameters, and duration and control of T2DM. METHODS: An analytical cross-sectional study was conducted in a tertiary care setup in 126 subjects which included 42 subjects with T2DM between 30 and 60 years of age, age-matched with 84 non-diabetic subjects. The subjects were evaluated for pure tone average (PTA), speech identification score (SIS), AR parameters [acoustic reflex threshold (ART), acoustic reflex amplitude (ARA), acoustic reflex latency (ARL)] and RDT. RESULTS: The subjects with T2DM showed increased PTA in both ears when compared to the subjects with no disease. No significant difference was found in the SIS between both groups. There was no significant difference in the ART and ARL between the two groups. There was a significant difference in the ipsilateral and contralateral ARA at 500 Hz, 1000 Hz and broadband noise (BBN) when compared between the diabetic and non-diabetic groups. No significant difference was found between average AR parameters and duration and control of T2DM. CONCLUSION: T2DM increases hearing thresholds and reduces ipsilateral and contralateral AR at lower frequencies and BBN. Duration and control of T2DM do not affect the AR parameters.

Ovarian hydatid cyst: an uncommon site of presentation

ABSTRACT Hydatid cyst is a parasitic infestation caused by Echinococcus larvae. Hydatid cyst of the ovary is a highly unusual presentation. Herein, we present a case of a young woman who complained of episodic lower abdominal pain. Ultrasound of the abdomen revealed a multi-cystic left adnexal mass measuring 86 mm x 67 mm. A possibility of ovarian cystic neoplasm was suggested. Unilateral salpingo-oophorectomy was performed. On histopathological examination, a cyst measuring 8.0 x 5.5 x 4.5 cm was found, replacing the entire ovary. The cyst cavity was filled with serous fluid and multiple pearly white membranous structures, giving a multiloculated appearance. Microscopic examination showed a cyst lined by a lamellar membrane containing protoscolices and hooklets. Hydatid disease is a zoonotic ailment caused by tapeworms (Echinococcus granulosus or, less commonly, Echinococcus multilocularis). The definitive hosts are carnivores. Humans are the accidental intermediate hosts. The hydatid cyst commonly affects the liver and the lungs. The primary hydatid cyst of the ovary is quite rare, with few case reports in the literature. In most cases, symptoms are vague, and the lesion is misdiagnosed as benign or malignant ovarian cystic neoplasm on clinical and radiological examination. Ovarian hydatid cyst is treated by surgery with ovarian cystectomy as the gold standard. The possibility of a hydatid cyst should be kept under differential diagnoses while evaluating the cystic diseases of the ovary.

Assessment of otolith function using vestibular evoked myogenic potential in women during pregnancy / Avaliação da função otolítica através do potencial evocado miogênico vestibular em mulheres durante a gravidez

Abstract Introduction: More than 50% of pregnant women experience dizziness frequently in the first two gestational trimesters. During pregnancy, the changes in the metabolism of hormones are responsible for the ovarian cycle resulting in either peripheral or central vestibular alterations. The need for the study is to focus on the effect of changes during pregnancy on the vestibular evoked myogenic potential, an electrophysiological measure that investigates functions of the otolith structures. Objectives: The aim is to investigate the vestibular evoked myogenic potential responses during the first trimester of pregnancy. Methods: A total of 17 pregnant women and 17 non-pregnant women with age matched took part in this study. The cervical vestibular evoked myogenic potential were recorded from the ipsilateral sternocleridomastoid muscle and the ocular vestibular evoked myogenic potential were recorded from contralateral extraocular muscle in both groups. Results: Peak to peak amplitude of cervical vestibular evoked myogenic potential and ocular vestibular evoked myogenic potential was found to be significantly reduced in the responses obtained from first-trimester pregnant women when compared to that of non-pregnant women. Conclusions: Vestibular evoked myogenic potential tests exhibits a clinically significant reduced peak to peak amplitude in the first trimester of pregnancy, which indicates dysfunction in the otolith reflex pathway.

Resumo Introdução: Mais de 50% das mulheres grávidas apresentam tonturas frequentes nos primeiros dois trimestres da gravidez. Durante a gestação, as mudanças no metabolismo dos hormônios são responsáveis pelo ciclo ovariano, resultam em alterações vestibulares periféricas ou centrais. A necessidade do estudo é enfocar o efeito das mudanças durante a gravidez sobre o potencial evocado miogênico vestibular, uma medida eletrofisiológica que investiga as funções das estruturas otolíticas. Objetivo: Investigar as respostas do potencial evocado miogênico vestibular no primeiro trimestre da gravidez. Método: Participaram deste estudo 17 mulheres grávidas e 17 não grávidas com idades pareadas. O potencial evocado miogênico vestibular cervical foi registrado a partir do músculo esternocleidomastóideo ipsilateral e o potencial evocado miogênico vestibular ocular foi registrado a partir do músculo extraocular contralateral em ambos os grupos. Resultados: A amplitude pico a pico do potencial evocado miogênico vestibular cervical e do potencial evocado miogênico vestibular ocular estava significativamente reduzida nas respostas obtidas de mulheres grávidas no primeiro trimestre de gestação quando comparadas a de mulheres não grávidas. Conclusão: Os testes de potencial evocado miogênico vestibular mostram uma redução clinicamente significativa na amplitude pico a pico no primeiro trimestre da gravidez, o que indica disfunção na via otolítica reflexa.

Cortical auditory potentials and cognitive potentials in individuals with and without vestibular dysfunction.

Background: Among individuals with vestibular dysfunction, the loss of vestibular sensory information is found to alter cognitive abilities that coordinate spatial and non-spatial information. P300 is an event-related potential commonly used to assess cognitive processing. The aim of the present study was to compare the latency and amplitude of cortical auditory evoked potential and P300 between individuals with vestibular dysfunction and individuals with no vestibular dysfunction. Methods: Forty adults with a mean age of 40.5 ± 13.07 participated in the study. Group I included 20 adults diagnosed with vestibular dysfunction and group II included 20 age-matched adults with no vestibular dysfunction. The P300 was recorded from the electrode site Cz and Pz. It was elicited using pure-tones in odd-ball paradigm. The latency and amplitude of peaks P1, N1, P2, and N2 of the cortical auditory evoked potential and the P300 were measured. Results: Significant amplitude difference was observed in cortical potentials at Cz and Pz. The P300 was present only in 70% of individuals with vestibular dysfunction compared to 100% among individuals with no vestibular dysfunction. The mean amplitude of the P300 was slightly larger in group 1 compared to group 2 and the mean latency of the P300 was similar in both groups. However, the difference in amplitude of the P300 between groups was not statistically significant. Conclusions: Knowing the cognitive function of individuals with vestibular dysfunction enables planning vestibular rehabilitation therapy, which enhances the quality of life in these individuals by improving their vestibular and cognitive functions.

Assessment of otolith function using vestibular evoked myogenic potential in women during pregnancy.

INTRODUCTION: More than 50% of pregnant women experience dizziness frequently in the first two gestational trimesters. During pregnancy, the changes in the metabolism of hormones are responsible for the ovarian cycle resulting in either peripheral or central vestibular alterations. The need for the study is to focus on the effect of changes during pregnancy on the vestibular evoked myogenic potential, an electrophysiological measure that investigates functions of the otolith structures. OBJECTIVES: The aim is to investigate the vestibular evoked myogenic potential responses during the first trimester of pregnancy. METHODS: A total of 17 pregnant women and 17 non-pregnant women with age matched took part in this study. The cervical vestibular evoked myogenic potential were recorded from the ipsilateral sternocleridomastoid muscle and the ocular vestibular evoked myogenic potential were recorded from contralateral extraocular muscle in both groups. RESULTS: Peak to peak amplitude of cervical vestibular evoked myogenic potential and ocular vestibular evoked myogenic potential was found to be significantly reduced in the responses obtained from first-trimester pregnant women when compared to that of non-pregnant women. CONCLUSIONS: Vestibular evoked myogenic potential tests exhibits a clinically significant reduced peak to peak amplitude in the first trimester of pregnancy, which indicates dysfunction in the otolith reflex pathway.

Auditory Brainstem Response in Children with Thalassemia Major under Chelating Therapy.

The present study compared the Auditory Brainstem Response (ABR) of children with thalassemia major and typically developing children. A total of 16 children participated in this study. Group I included 8 children with thalassemia major regularly undergoing blood transfusions and chelating therapy. Group II included 8 age and gender-matched typically developing children. All children in both groups had hearing sensitivity within normal limits. The Auditory Brainstem Response (ABR) was recorded monaurally for click stimuli from both ears. Results showed that the mean latencies of peaks of ABR were similar in both groups. The mean peak amplitude of peaks I and V of the ABR were different between groups, but it was not statistically significant. The present study showed no abnormality in the latency and amplitude of peaks of the ABR in children with thalassemia major with hearing sensitivity within normal limits.

The effect of coffee on contralateral suppression of transient evoked otoacoustic emissions.

Background: Coffee is a popular non-alcoholic beverage consumed by humans across the world. It contains caffeine, which is a type of stimulant of the central nervous system. In the auditory system, it has a positive effect on auditory brainstem response and perception of speech in noise. Further, caffeine has an inhibitory effect in the cochlea, but studies have rarely investigated its effect on otoacoustic emissions (OAEs) in humans. OAEs are low-intensity sounds produced by the cochlea, which could be recorded in the ear canal. The present study was carried out to investigate the effect of coffee on transient evoked otoacoustic emission (TEOAE) and contralateral suppression of TEOAE. Method: A total of 52 young adults participated in the study. A cross-over study design was used for the present investigation. The TEOAE and contralateral suppression of TEOAE were recorded before and after consumption of coffee and milk. The contralateral suppression of TEOAE was measured by presenting white noise to the contralateral ear at 40, 50, and 60 dB sound pressure level (SPL). Results: The mean amplitude of TEOAE before and after consumption of coffee was similar in both ears. Further, the mean contralateral suppression of TEOAE was slightly larger after consumption of coffee in both ears. However, the mean difference was not significant in both the ears. Conclusions: Based on the findings of present study, coffee has no significant effect on the amplitude of TEOAE and contralateral suppression of TEOAE.

Vestibular evoked myogenic potentials in chronic renal disease.

BACKGROUND: There is limited evidence to provide an insight on the VEMP characteristics to explain the association between chronic renal disease (CRD) and its effect on otolith structures. OBJECTIVE: To compare the otolithic function of individuals with CRD and individuals with no known CRD. To investigate the relationship between disease duration and VEMP and creatine level and VEMP among individuals with CRD. METHOD: A cross-sectional study design using convenient sampling method was adapted for the present study. A total of 50 adults aged between 40 and 60 years participated in the study. Group 1 included 25 individuals with CRD undergoing hemodialysis and Group 2 included 25 individuals with no known CRD. cVEMP and oVEMP were recorded from participants in both groups. RESULTS: cVEMP and oVEMP was absent in 28% and 44% of individuals with CRD respectively, while, both VEMPs were present among all participants in group 2. Further, peak-to-peak amplitude of VEMP was reduced in individuals with CRD suggesting abnormal otolith function. In addition, a negative correlation was found between disease duration and the peak-to-peak amplitude of VEMP. CONCLUSION: The abnormal VEMP findings in individuals with CRD shows presence of otolithic dysfunction along with amplitude is found to decrease with an increase in the disease duration.

Temporal processing, spectral processing, and speech perception in noise abilities among individuals with chronic kidney disease undergoing hemodialysis.

BACKGROUND: In the literature, the effect of chronic kidney disease on the peripheral auditory system has been well documented. But studies investigating the effect of chronic kidney disease on speech perception and auditory processing abilities are limited. AIMS/OBJECTIVES: The present study investigated the effect of chronic kidney disease on different auditory processing tasks and speech perception in noise among adults. MATERIAL AND METHODS: A total of 28 adults participated in the study. Group 1 included 14 individuals with chronic kidney disease undergoing hemodialysis, and Group 2 included 14 individuals with no known kidney complications. Amplitude modulation detection threshold, gap detection threshold, spectral ripple discrimination threshold, and speech recognition threshold in noise were measured. Independent samples t-test was carried out to investigate whether mean thresholds are significantly different between groups. RESULTS: Results showed poorer gap detection threshold, amplitude modulation detection threshold, spectral ripple discrimination threshold, and speech recognition threshold in noise among individuals with chronic kidney disease compared to individuals with no known kidney complications. CONCLUSIONS: The present study showed poorer auditory processing and speech perception abilities in individuals with chronic kidney disease.

A comparison of temporal processing and spectral processing abilities of monolingual, bilingual and multilingual children.

Objective: This study examined the effects of bilingualism and multilingualism on supra-threshold auditory processing abilities in children.Design: Cross-sectional study.Study sample: Ninety children participated in the study, based on the number of languages they know children were assigned into three groups, i.e. monolingual, bilingual and multilingual. Amplitude modulation detection threshold, gap detection threshold, pitch discrimination threshold and spectral ripple discrimination threshold were measured.Results: Results showed superior supra-threshold auditory processing abilities among multilingual and bilingual children than monolingual children. The results further showed that, the supra-threshold auditory processing of multilingual children was better than bilingual children.Conclusion: This finding suggests that knowledge of multiple languages improves supra-threshold auditory processing abilities. This study adds to the growing body of literature supporting the superior supra-threshold auditory processing abilities among bilingual and multilingual individuals.

Test-Retest Reliability of Cervical and Ocular Vestibular Evoked Myogenic Potential With Simultaneous and Sequential Recording.

Purpose Simultaneous recording of cervical (cVEMP) and ocular (oVEMP) vestibular evoked myogenic potentials aids in reducing the testing time when compared to conventional sequential recordings. The purpose of this study was to examine the test-retest reliability of sequential and simultaneous acquisitions of cVEMP and oVEMP. Method cVEMP and oVEMP were recorded in 35 normal-hearing individuals. The cVEMP and oVEMP were obtained using sequential and simultaneous methods. The VEMP recordings were performed across 3 sessions. The 1st 2 recording sessions were consecutive with a gap of 5 min between sessions. The 3rd recording session was after a gap of 3-5 days. Results Both simultaneous and sequential recordings showed fair-to-good test-retest reliability for latencies and amplitude of cVEMP and oVEMP. Conclusion Simultaneous cVEMP and oVEMP recordings can be used to obtain fast VEMP recording with test-retest reliability comparable with that of sequential recording.

Comparison of Vestibular Evoked Myogenic Potential and Dizziness Handicap Inventory in Patient with Peripheral Vestibular Lesions between Pre and Post Vestibular Rehabilitation.

AIM AND OBJECTIVE: VEMP is brief latency electromyography and is elicited by a high-intensity auditory stimulus. The aim of the current study was to compare VEMP and DHI in patients with peripheral vestibular lesions between pre and post vestibular rehabilitation. METHOD: A total of 30 participants with peripheral vestibular lesions were considered, among which 15 were given vestibular rehabilitation, and 15 were not given vestibular rehabilitation. The participants were subjected for cVEMP, oVEMP, and DHI testing before and after vestibular rehabilitation. RESULT: The latency and peak to peak amplitude measures showed no major difference among the training phase and between training and group for both cVEMP and oVEMP responses. However, the DHI scores were found to be significantly improved after vestibular training in the participants with dizzness. The above findings explain that even in the presence of peripheral vestibular lesion, symptomatic relief from vertiginous symptoms is possible. CONCLUSION: These were inculcated by vestibular rehabilitation prompted vestibular compensation. Vestibular rehabilitation should be practiced among individuals with peripheral vestibular lesions, irrespective of age.