Galvanic vestibular evoked myogenic potentials: normative data and the effect of age / Potenciais evocados miogênicos vestibulares galvânicos: dados normativos e o efeito da idade

Abstract Introduction: Galvanic vestibular evoked myogenic potentials evaluate vestibular nerve responses using electric stimulation by records collected from the sternocleidomastoid muscle. A normal vestibular evoked myogenic potential response consists of the first positive, P1, and negative, N1, peaks. The response can be affected by factors such as age and gender and is also consequential in the diagnosis of pathologies. Objectives: The present study was performed to obtain normative data on healthy adults, to help in diagnosis by establishing clinical norms as well as to investigate changing test parameters with age in galvanic vestibular evoked myogenic potentials. Methods: A total of 100 healthy participants were included in the study. Galvanic vestibular evoked myogenic potential (current 3 mA, duration 1ms) was performed randomly on both ears of each participant. The participants between the ages of 18-65 (mean age 39.7 ± 13.9) were divided into 5 groups according to their ages. Normative data of galvanic vestibular evoked myogenic potentials parameters were calculated in groups and in total, and age-related changes were examined. Results: The galvanic vestibular evoked myogenic potential waveform was elicited from all participants (200 ears). The latency of P1 and N1 was 7.82 ± 3.29ms and 22.06 ± 3.95 ms, respectively. The P1-N1 amplitude value was 66.64 ± 24.5 μV. The percentage of vestibular asymmetry was 16.29 ±11.99%. The latencies of P1 and N1 and P1-N1 amplitude values demonstrated significant differences among different age groups (p < 0.01). Conclusions: The results of this study show that as age increased, latencies were prolonged, and amplitudes gradually decreased. The normative data aids in the diagnosis of retrolabyrinthine lesions and the increase in the clinical use of galvanic vestibular evoked myogenic potentials.

Resumo Introdução: Os potenciais evocados miogênicos vestibulares galvânicos avaliam as respostas do nervo vestibular com estimulação elétrica por meio de registros coletados do músculo esternocleidomastóideo. Uma resposta normal de potenciais evocados miogênicos vestibulares consiste nos primeiros picos positivo, P1, e negativo, N1. A resposta pode ser afetada por fatores como idade e sexo e também tem importância no diagnóstico de doenças. Objetivos: Obter dados normativos em adultos saudáveis, para ajudar no diagnóstico através do estabelecimento de normas clínicas, e investigar a alteração dos parâmetros de teste com a idade em potenciais evocados miogênicos vestibulares galvânicos. Método: Foram incluídos no estudo 100 participantes saudáveis. O potencial evocado miogênico vestibular galvânico (corrente 3mA, duração 1ms) foi realizado de forma aleatória nas duas orelhas de cada participante. Os participantes entre 18 e 65 anos (média de 39,7 ±13,9) foram divididos em 5 grupos de acordo com a idade. Os dados normativos dos parâmetros dos potenciais evocados miogênicos vestibulares galvânicos foram calculados nos grupos e no total e as alterações relacionadas à idade foram examinadas. Resultados: A forma de onda do potencial evocado miogênico vestibular galvânico foi obtida de todos os participantes (200 orelhas). A latência de P1 e N1 foi de 7,82±3,29ms e 22,06 ±3,95 ms, respectivamente. O valor da amplitude P1-N1 foi de 66,64 ±24,5 μV. O percentual de assimetria vestibular foi de 16,29± 11,99%. Os valores das latências de P1 e N1 e da amplitude P1-N1 mostraram diferenças significantes entre os diferentes grupos etários (p < 0,01). Conclusão: Os resultados deste estudo mostram que à medida que a idade aumentou as latências foram prolongadas e as amplitudes diminuíram gradualmente. Os dados normativos auxiliam no diagnóstico de lesões retrolabirínticas e na disseminação do uso clínico dos potenciais evocados miogênicos vestibulares galvânicos.

Galvanic vestibular evoked myogenic potentials: normative data and the effect of age.

INTRODUCTION: Galvanic vestibular evoked myogenic potentials evaluate vestibular nerve responses using electric stimulation by records collected from the sternocleidomastoid muscle. A normal vestibular evoked myogenic potential response consists of the first positive, P1, and negative, N1, peaks. The response can be affected by factors such as age and gender and is also consequential in the diagnosis of pathologies. OBJECTIVES: The present study was performed to obtain normative data on healthy adults, to help in diagnosis by establishing clinical norms as well as to investigate changing test parameters with age in galvanic vestibular evoked myogenic potentials. METHODS: A total of 100 healthy participants were included in the study. Galvanic vestibular evoked myogenic potential (current 3 mA, duration 1 ms) was performed randomly on both ears of each participant. The participants between the ages of 18-65 (mean age 39.7 ±â€¯13.9) were divided into 5 groups according to their ages. Normative data of galvanic vestibular evoked myogenic potentials parameters were calculated in groups and in total, and age-related changes were examined. RESULTS: The galvanic vestibular evoked myogenic potential waveform was elicited from all participants (200 ears). The latency of P1 and N1 was 7.82 ±â€¯3.29 ms and 22.06 ±â€¯3.95 ms, respectively. The P1-N1 amplitude value was 66.64 ±â€¯24.5 µV. The percentage of vestibular asymmetry was 16.29 ±â€¯11.99%. The latencies of P1 and N1 and P1-N1 amplitude values demonstrated significant differences among different age groups (p < 0.01). CONCLUSIONS: The results of this study show that as age increased, latencies were prolonged, and amplitudes gradually decreased. The normative data aids in the diagnosis of retrolabyrinthine lesions and the increase in the clinical use of galvanic vestibular evoked myogenic potentials.

Comparison of Real-Time Speech Magnetic Resonance Imagings With Perceptual Speech Analysis in Evaluation Velopharyngeal Sphincter Function.

ABSTRACT: Identifying substantial data and their normative values related to velopharyngeal structures in cleft palate patients may have clinical significance, in order to selection of surgical intervention and prediction of postsurgical outcomes. Previous studies are lack of referring certain anatomic locations or distances that may have affect on speech intelligibility, especially in dynamic state. The aim of this study is to investigate effectiveness of magnetic resonance imagings on the velopharyngeal sphincter function and the correlation with speech intelligibility after functional cleft palate repair. Seventeen patients with repaired cleft palate by single surgeon were enrolled in this study.Quantitative velopharyngeal measures from the oblique coronal plane and midsagittal plane in static and dynamic positions were collected. Patients' speech intelligibility was evaluated by using Pittsburgh Weighted Speech Scale and nasalance score was also measured. Correlation analysis methods were used for evaluating relation between MRI gathered measurements and speech intelligibility scores for determiningconsequential data.Our study shows that the velar knee-posterior pharyngeal wall distance measurement while explosive sound production is the most related data with speech intelligibility. Although future works with more sample number is needed, according to current study the authors think magnetic resonance imagings is a very helpful method in providing reliable information.

Changes in electrically evoked auditory brainstem responses in children with sequential bilateral cochlear implants.

OBJECTIVES: The primary aim of this study is to investigate whether the electrical stimulation of the second ear causes a difference in electrically evoked auditory brainstem responses (eABR) between two ears over time. METHODS: The study included thirteen subjects under the age of five who used cochlear implants for at least six months in the first ear prior to the sequential cochlear implantation. Postoperative eABRs were conducted on the 1st (first fitting of the second speech processor), 3rd, and 6th months of the second implantation in the basal, medial, and apical electrode positions. The recording was started with the second cochlear implant (CI2), and then the first cochlear implant (CI1) was tested. Sound field audiometry and receptive/expressive language assessments were also performed at 1 and 6 months after the second cochlear implantation. RESULTS: eABR results indicate that when eV wave latencies are examined for all electrodes, CI2 is significantly longer than CI1 (p < 0.05). When eV wave amplitudes are examined for all electrodes, CI1 is significantly higher than the CI2 (p < 0.05). eV latency and amplitude changes between both implants were examined up to six months after implantation. Statistically significant changes were observed in the basal, medial, apical electrode for eV wave latencies, and only in the medial electrode for eV wave amplitudes (p < 0.05). Average sound field thresholds and receptive/expressive language scores improved statistically significantly for all subjects at the end of the study (p < 0.05). CONCLUSION: The postoperative eABR test is a valuable test battery that provides the clinician with important ideas about the estimated threshold, comfortable and audible sound level, CI performance, and auditory pathways up to the brainstem. Since the maturation is still ongoing, an extended period longer than six months is needed to evaluate interaural differences.

Otoacoustic Emissions in Young Children with Autism.

OBJECTIVE: The aim of this study is to investigate otoacoustic emissions (OAEs) in young children with autism compared with those in an age-matched control group. MATERIALS AND METHODS: Thirty-eight children with autism aged 3-6 years and 27 typically developing (normally developing) control subjects participated in this study. All the participants had normal hearing and middle-ear function. Auditory brainstem responses were used to determine the hearing status in the autism group. Transient-evoked otoacoustic emissions (TEOAEs) and distortion-product otoacoustic emissions (DPOAEs) were measured in the two groups. RESULTS: The TEOAE response level was higher in the autism group. Analysis of the DPOAE response showed that the mean emission levels at 1.5, 2 , 3, and 6 kHz and signal/noise ratios at 2, 4, 6, and 8 kHz were higher in the autism group (p<0.05). The greatest between-group differences were observed in the DPOAE signal levels at 2, 3, and 6 kHz (p=0.000). No statistically significant difference was found between the noise levels in the autism and control groups (p>0.05). CONCLUSION: The emission responses in the autism group were higher than those in the control group. The increase in DPOAEs at high frequencies may be related to the higher outer cell activation in the autism group. Further studies with larger sample sizes comprising younger children are needed to confirm the result and investigate the possible association between the increased OAEs and auditory sensitivity reported in autism.

Assessment of the Speech Intelligibility Performance of Post Lingual Cochlear Implant Users at Different Signal-to-Noise Ratios Using the Turkish Matrix Test.

BACKGROUND: Spoken word recognition and speech perception tests in quiet are being used as a routine in assessment of the benefit which children and adult cochlear implant users receive from their devices. Cochlear implant users generally demonstrate high level performances in these test materials as they are able to achieve high level speech perception ability in quiet situations. Although these test materials provide valuable information regarding Cochlear Implant (CI) users' performances in optimal listening conditions, they do not give realistic information regarding performances in adverse listening conditions, which is the case in the everyday environment. AIMS: The aim of this study was to assess the speech intelligibility performance of post lingual CI users in the presence of noise at different signal-to-noise ratio with the Matrix Test developed for Turkish language. STUDY DESIGN: Cross-sectional study. METHODS: The thirty post lingual implant user adult subjects, who had been using implants for a minimum of one year, were evaluated with Turkish Matrix test. Subjects' speech intelligibility was measured using the adaptive and non-adaptive Matrix Test in quiet and noisy environments. RESULTS: The results of the study show a correlation between Pure Tone Average (PTA) values of the subjects and Matrix test Speech Reception Threshold (SRT) values in the quiet. Hence, it is possible to asses PTA values of CI users using the Matrix Test also. However, no correlations were found between Matrix SRT values in the quiet and Matrix SRT values in noise. Similarly, the correlation between PTA values and intelligibility scores in noise was also not significant. Therefore, it may not be possible to assess the intelligibility performance of CI users using test batteries performed in quiet conditions. CONCLUSION: The Matrix Test can be used to assess the benefit of CI users from their systems in everyday life, since it is possible to perform intelligibility test with the Matrix test using a material that CI users experience in their everyday life and it is possible to assess their difficulty in speech discrimination in noisy conditions they have to cope with.

Wideband Tympanometry Normative Data for Turkish Young Adult Population.

OBJECTIVE: The aim of this study was to obtain norm values for a young adult Turkish group and to investigate the differences between female and male subjects in terms of wideband tympanometry. MATERIALS AND METHODS: One hundred ten young adult volunteers (mean±SD: 21.1±1.9 years) participated in this study. The measurements of wideband tympanometry were performed at octave frequencies between 226 Hz and 8000 Hz using Titan version 3.1. The stimulus level was set at 100 dB peSPL. RESULTS: A cross-sectional study design was used. In total, 218 ears were tested. A significant relationship was found between gender and absorbance values for the frequency band from 3100 Hz to 6900 Hz. The difference between the middle ear resonance frequency and ear canal volume (ECV) of the male and female subjects was also found to be significant. The difference in ECV may result from the difference in body size between the male and female subjects because there was a significant relationship among ECV and the height and weight. CONCLUSION: According to these results, it can be concluded that using separate norms for males and females may increase test specificity and sensitivity for the diagnosis of disorders, such as ossicular discontinuity and tympanic membrane perforations, affecting the high-frequency region.

The investigation of cortical auditory evoked potentials responses in young adults having musical education.

BACKGROUND: In the literature, music education has been shown to enhance auditory perception for children and young adults. When compared to young adult non-musicians, young adult musicians demonstrate increased auditory processing, and enhanced sensitivity to acoustic changes. The evoked response potentials associated with the interpretation of sound are enhanced in musicians. Studies show that training also changes sound perception and cortical responses. The earlier training appears to lead to larger changes in the auditory cortex. AIMS: Most cortical studies in the literature have used pure tones or musical instrument sounds as stimuli signals. The aim of those studies was to investigate whether musical education would enhance auditory cortical responses when speech signals were used. In this study, the speech sounds extracted from running speech were used as sound stimuli. STUDY DESIGN: Non-randomized controlled study. METHODS: The experimental group consists of young adults up to 21 years-old, all with a minimum of 4 years of musical education. The control group was selected from young adults of the same age without any musical education. The experiments were conducted by using a cortical evoked potential analyser and /m/, /t/ /g/ sound stimulation at the level of 65 dB SPL. In this study, P1 / N1 / P2 amplitude and latency values were measured. RESULTS: Significant differences were found in the amplitude values of P1 and P2 (p<0.05). The differences among the latencies were not found to be significantly important (p>0.05). CONCLUSION: The results obtained in our study indicate that musical experience has an effect on the nervous system and this can be seen in cortical auditory evoked potentials recorded when the subjects hear speech.