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DOI: 10.3766/jaaa.288ceu
JAAA CEU Program
Volume 28, Number 8 (September 2017)Publikationsverlauf
Publikationsdatum:
26. Juni 2020 (online)
Questions refer to Portnuff et al, “Safe Use of Acoustic Vestibular-Evoked Myogenic Potential Stimuli: Protocol and Patient-Specific Considerations,” 708–717.
Learner Outcomes:
Readers of this article should be able to:
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Summarize the risk of hearing loss from high stimulus presentation levels used in testing vestibular evoked myogenic potentials (VEMPs).
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Discuss how stimulus parameters for recording VEMPs must be evaluated to minimize noise induced hearing loss.
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Vestibular evoked myogenic potentials (VEMPs) originating from the sternocleidomastoid muscle are:
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cervical VEMPs (cVEMPs)
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ocular VEMPs (oVEMPs)
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triceps VEMPs (tVEMPs)
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Acoustic stimuli considered most effective in eliciting VEMPs are:
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250 Hz bone conduction clicks
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500 Hz air conduction tone bursts
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short duration electrical clicks
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Mattingly et al (2015) observed sudden permanent sensorineural hearing loss after VEMP testing with stimuli of:
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95 – 100 dB nHL
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128 and 135 dB pSPL
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133 dB pSPL
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Price (1981) suggested that for ears at the 25th percentile of susceptibility, the critical level for instantaneous damage by impulsive noises was:
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132 dB pSPL
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136 dB pSPL
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140 dB pSPL
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Based on Beattie and Rochverger (2001), the difference between a “fast response” sound level meter reading of a 500 Hz tone burst, and the actual peak value is approximately:
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3 dB
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6 dB
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12 dB
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To assess risk for acoustic trauma from VEMP stimuli, the authors recommend establishing presentation levels in:
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dB m
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dB nHL or dB HL
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dB pSPL or dB peSPL
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Reducing ear canal volume from 2.0 cc to 1.0 cc changes a stimulus level by a(n):
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decrease of 6 dB
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increase of 3 dB
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increase of 6 dB
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The benefit of VEMP testing might not outweigh the risk for noise induced hearing loss for:
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cochlear implant candidates
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elderly patients (> 70 years of age)
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patients with superior semicircular canal dehiscence (SSCD)
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When SSCD is suspected, VEMP testing:
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can begin at lower starting presentation levels
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requires a larger number of trials
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should not be conducted
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In the authors' protocol for VEMP stimuli designed not to exceed NIOSH noise exposure values, fewer total sweeps are recommended for
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cVEMPs
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oVEMPs
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tVEMPs
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Die Autoren geben an, dass kein Interessenkonflikt besteht.