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    Effects of Covid-19 on the audio-vestibular system
    (W B Saunders Co-Elsevier Inc, 2021) Tan, Mehmet; Cengiz, Deniz Ugur; Demir, Ismail; Demirel, Sumeyye; Colak, Sanem Can; Karakas, Oguz; Bayindir, Tuba
    Purpose: It was aimed to investigate the effects of COVID-19 infection on hearing and the vestibular system. Methods: Twenty-six patients whose treatment had been completed and who had no previous hearing or balance complaints were included in the study. Patients diagnosed with the disease by PCR were included in the study. Patients with at least one month of illness were included in the study. The hearing of patients was evaluated with transient evoked otoacoustic emissions (TEOAE) and pure-tone audiometry. Bedside tests, the European Evaluation of Vertigo scale (EEV), Video Head Impulse Test (vHIT), Ocular Vestibular Myogenic Evoked Potential (oVEMP), Cervical Vestibular Myogenic Evoked Potential (cVEMP) and Videonystagmography (VNG) tests were applied to evaluate the vestibular system. Results: A statistically significant difference was found between the COVID-19 positive and control groups according to the mean values of the 4000 Hz and 8000 Hz in both the right and left ears (p < 0.05). No statistically significant difference was found in the other frequencies and TEOAE. No statistically significant difference was found between the COVID-19 positive and control groups in terms of their normal or pathological VNG saccade, optokinetic and spontaneous nystagmus values (p > 0.05). The normal and pathological VNG head shake values were found to be significantly different between the COVID-19 positive and control groups (p < 0.05). Conclusion: The high frequencies in audiometry in the COVID-19 positive group were worse than those in the control group. In the vestibular system, especially in oVEMP and cVEMP, asymmetric findings were obtained in comparison to the control group, and a low gain in vHIT was shown. This study shows that the audiovestibular system of people with COVID-19 infection may be affected.
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    EFFECTS OF GAZE POSITION ON OCULAR VESTIBULAR EVOKED MYOGENIC POTENTIAL (oVEMP)
    (Dokuz Eylul Univ Inst Health Sciences, 2023) Cengiz, Deniz Ugur; Demir, Ismail; Colak, Sanem Can; Demirel, Sumeyye; Karababa, Ercan; Bayindir, Tuba
    Purpose:To compare ocular vestibular evoked myogenic potential (oVEMP) responses obtained with superomedial and oblique gaze positions. Material and Methods:The oVEMP test was applied in 59 healthy subjects at superomedial, right oblique, and left oblique gaze positions. Stimuli were presented at 110 dB nHL with a frequency of 500 Hz. oVEMP responses were recorded via electrodes placed on the lower eyelids. Results:Higher N1-P1 amplitudes were obtained in oblique gaze positions in the stimulated ear direction compared to the superomedial position (p < 0.05). The asymmetry values obtained in the superomedial gaze position were lower than those obtained in oblique gaze positions (p < 0.05). The asymmetry values obtained in the Superomedial and oblique gaze positions had no effect on the N1, P1, and N1-P1 latencies of the waves obtained from the Conclusion:Superomedial and oblique gaze positions affect oVEMP waves. In patients in whom vestibular hypofunction is suspected, it is recommended to control oVEMP responses in oblique gaze positions as well as in superomedial gaze positions in the evaluation of the residual vestibular functions.
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    Evaluation of utricular and saccular function in BPPV patients: The role of VEMP in diagnosis
    (2020) Ugur Cengiz, Deniz; Emekci, Tugba; Demirel, Sumeyye; Can Colak, Sanem; Tan, Mehmet
    Aim: The pathological cause of Benign Paroxysmal Positional Vertigo (BPPV) is the degeneration of the otolith organs (utricle and sacculus). Vestibular Evoked Myogenic Potentials (VEMP) assess the functions of the otolith organs. The objective of this research was to evaluate the otolith organ functions of patients with unilateral idiopathic BPPV (canalolithiasis of the posterior and lateral semicircular canals) by cVEMP and oVEMP tests. Material and Methods: The study prospectively included 35 patients with BPPV (canalolithiasis of the posterior and lateral semicircular canals) and 30 healthy individuals. Bilateral cVEMP and oVEMP tests were administered to all participants. Participants were divided into three groups: control, BPPV-affected ear, and unaffected ear.Results: In our study, cVEMP and oVEMP abnormalities were statistically significantly different both between the affected and unaffected ear groups and between the affected ear and control groups. There were statistically significant differences in the cVEMP and oVEMP amplitude values both between the affected and unaffected ear groups and between the affected ear and control groups. Also, the asymmetry ratios of the cVEMP and oVEMP tests were statistically significantly different between the case group and the control group. The cVEMP and oVEMP wave latencies (p1, n1, p1-n1) were not statistically significantly different among the BPPV-affected ear, unaffected ear, and control groups. The results of measurements were not statistically significantly different between the posterior and lateral canal involvement subgroups of BPPV patients.Conclusion: Abnormal cVEMP and oVEMP test results, which are observed more frequently in patients with BPPV compared to the control group, indicate utricular and saccular degeneration. Higher oVEMP abnormality ratios compared to those of cVEMP in BPPV patients suggest that utricular dysfunction may be more common than saccular dysfunction.