The Influence of Clicks versus Short Tone Bursts on the Vestibular Evoked Myogenic Potentials

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Abstract
Vestibular evoked myogenic potential (VEMP) has become a diagnostic tool to evaluate the integrity of sacculo-collic reflex. To obtain a more consistent VEMP response in normal-hearing subjects, we examine whether clicks or short tone bursts are more effective in eliciting VEMP responses. Prospective study. Twenty-nine normal-hearing volunteers (58 ears) were given VEMP tests. Clicks and short tone bursts were presented alternately to evoke VEMPs. The latencies of peak p13 and n23, peak-to-peak interval and amplitude (p13-n23) were measured and compared. Click stimulation of 57 ears (98%) produced VEMPs (C-VEMPs), whereas 51 (88%) revealed positive short tone burst-evoked VEMPs (STB-VEMPs), exhibiting a significant difference (p < 0.05). Furthermore, C-VEMPs displayed shorter latency, longer interval and larger amplitude than STB-VEMPs, with a significant difference (p < 0.05), respectively. C-VEMPs had a higher response rate, shorter latency, and larger amplitude than STB-VEMPs. These findings suggest that click is superior to short tone burst to trigger VEMPs. Because C-VEMPs have a shorter p13 latency than STB-VEMPs, the interpretation of prolonged latency differs in each stimulus condition.