Defining Norms, Reliability, and Thresholds for Tone Burst-Induced Masseter Vestibular-Evoked Myogenic Potential Testing Through Bone Conduction

Background and Objectives: Masseter vestibular-evoked myogenic potentials (mVEMPs) provide a noninvasive approach for assessing saccular and vestibular nerve function. Although air-conducted stimuli are commonly used, bone-conduction stimulation offers advantages for individuals with conductive hearing loss. This study aimed to establish normative values and evaluate the test-retest reliability of BC-induced mVEMP using 500 Hz tone bursts in young adults. Subjects and Methods: This normative study included 45 healthy participants (aged 18-35). Bone conduction mVEMPs were elicited using 500 Hz tone bursts delivered through a B71 RadioEar vibrator. Responses from the masseter muscle were recorded using surface electrodes placed in a zygomatic montage. Participants underwent two test sessions within 1 month. The assessed parameters included P1 and N1 latencies, peak-to-peak amplitude, and asymmetry ratio. Threshold estimation was performed on a subset of 15 participants to determine response detectability. Results: Normative values revealed consistent P1 and N1 latencies across sessions with mean latencies of 11.76 ms and 14.77 ms, respectively. No significant interaural or sex-related differences were noted, except for ipsilateral P1 latency and contralateral N1 latency. The test-retest reliability ranged from fair to good, particularly for the P1 latency and asymmetry ratio. Threshold responses were reliably elicited at intensities up to 115 dB SPL. Conclusions: Bone conduction mVEMP elicited stable and reproducible responses in healthy young adults, supporting its clinical utility, particularly in patients with conductive pathology, those with reduced neck muscle strength, and within geriatric populations.