Diagnostic Application of Vestibular Evoked Myogenic Potentials in Cochleovestibular Disorders: A Cross-Sectional Analysis

A BSTRACT Background: Vestibular evoked myogenic potentials (VEMP) abnormalities have been reported in various auditory and vestibular diseases. However, literature on comparative diagnostic efficacy between VEMP and electronystagmography (ENG) remains limited, particularly among Indians. Thus, the present study aimed to assess clinical applications of VEMP and compare its findings with ENG. Materials and Methods: This cross-sectional study was conducted over 24 months in the Department of Otorhinolaryngology of a tertiary care center. Medcalc software was used to calculate sensitivity and specificity of VEMP test. The study included 100 patients undergoing non-caloric ENG, caloric ENG, VEMP (P13–N23) latency and amplitude. P13 amplitude is the amplitude and n23 is latency of VEMP test, according to which otolith organ dysfunction is tested and standard audiology. Associations between ENG and VEMP findings were evaluated, along with diagnostic yield for common vestibular diagnoses, with statistical significance at P < 0.05. Results: Majority of the patients were aged 21–35 years (37%), with slight male predominance (52%). VEMP showed age- and ear-specific variations in younger patients (≤50 years) for left ear P13 amplitudes (46.0 vs. 32.0%; P = 0.019) and N23 latencies (17.0 vs 6.0%; P = 0.012). Accordingly, amplitude latency of VEMP AUC values is seen with sensitivity 100% and latency with 65.2–96.9%. Comparative study shows with sensitivity 52.85% with specificity with 34.2% Positive Predictive Value (PPV) value 22.58% with 95% CI value = 16.36–30.31%, Negative Predictive value (NPV) 65.7%, with 95% CI value = 53.74–76.10%. Conclusions: A combination of VEMP and ENG enhances diagnostic discrimination, supporting a multimodal clinical approach.