Influence of bone conduction transducer type and placement on ocular and cervical vestibular evoked myogenic potentials

Evaluating the effectiveness of different bone conduction (BC) transducers with controlled coupling force to elicit cervical and ocular vestibular evoked myogenic potentials (cVEMPs, oVEMPs) in healthy subjects by comparing response rates, amplitudes, latencies, thresholds and asymmetry ratios. Prospective experimental study including healthy participants. VEMPs were measured to different stimulation modes; the BC transducer coupling force was controlled to 5.4 (± 0.5) Newton. cVEMPs: to bone conducted vibration (BCV) with the B81 transducer on the mastoid; oVEMPs: to BCV with the B81 on the mastoid, BCV with the B81 on the forehead, and BCV with the Mini-Shaker 4810 on the forehead. Air conducted sound (ACS) with insert earphones was used as reference. Data of 24 normal subjects (mean age 25.3 (± 3.0) years) were analyzed. ACS and BCV with the B81on the mastoid evoked cVEMPs in 100% of ears. The highest oVEMP response rates were obtained with the B81 on the mastoid (83–92%), the lowest with the B81 on the forehead (17–22%). The Mini-Shaker elicited lower response rates (65%) compared to results from the literature without coupling force control and compared to ACS (78–87%). Amplitudes were higher for BCV than ACS. ACS and BCV on the mastoid caused higher asymmetry compared to BCV forehead stimulation. The B81 was feasible to elicit VEMPs with mastoid placement and can be used as an approved medical device to measure BCV VEMPs in a clinical set-up. Normative asymmetry values have to be established due to higher variability for mastoid stimulation.