AudiologyOnline Phone: 800-753-2160


Signia Xperience - February 2024

Can I Use a Binaural/Bilateral Procedure for cVEMP Testing?

Kamran Barin, PhD

April 11, 2016

Share:

Question

I’m going to start performing cVEMP testing. Can I use a binaural/bilateral procedure?

Answer

Dr. Kamran Barin: When performing Cervical Vestibular Evoked Myogenic Potentials or cVEMP,  using a binaural or bilateral procedure is not recommended for clinical decision making.

The reason is related to the crossover effect where some of the response from one side shows up in testing of the other side.  For example, let’s assume we are able to measure VEMPs perfectly and the response from the right side is 100 microvolt and from the left is 30 microvolt.  The asymmetry ratio (AR) is:

AR = (100-30)/(100+30) = 54%

In real testing, let’s assume that there is a crossover effect and 20% of the response from one side shows up on the other side.  So the responses in binaural testing will be:

Right = response from right + 20% of response from left = 100 + 0.2*30 =100 + 6 = 106 microvolt

Left = response from left + 20% of response from right = 30 + 0.2*100 = 30 + 20 = 50 microvolt

AR = (106 – 50)/(106 + 50) = 36%

So, the asymmetry is underestimated.  This does not happen with monaural testing because there is no input to the other side; it only happens with binaural testing when there is a difference between right and left responses.

Further resources and information:


kamran barin

Kamran Barin, PhD

Kamran Barin, Ph.D. is Assistant Professor Emeritus, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University.  He served as the Director of Balance Disorders Clinic at the Ohio State University Medical Center for over 25 years until his retirement in June 2011.  He received his Master’s and Doctorate degrees in Electrical/Biomedical Engineering from the Ohio State University. He has taught national and international courses and seminars in different areas of vestibular assessment and rehabilitation.  Kamran Barin is a consultant to Otometrics and provides courses and other educational material to the company.


Related Courses

A Guide to Bithermal Caloric Testing
Presented by Amanda Cerka Mroz, AuD, FAAA, CCC-A
Recorded Webinar
Natus

Presenter

Amanda Cerka Mroz, AuD, FAAA, CCC-A
Course: #815Level: Intermediate1 Hour
  'Very concise and clear'   Read Reviews
No CEUs/Hours Offered
The purpose of this course is to provide an in-depth discussion of the caloric testing portion of the VNG/ENG test battery. Content will include descriptions of testing procedures, analysis and interpretation of results.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $99/yr

Learn More

A Guide to Bithermal Caloric Testing
Presented by Amanda Cerka Mroz, AuD, FAAA, CCC-A
Recorded Webinar
Natus

Presenter

Amanda Cerka Mroz, AuD, FAAA, CCC-A
Course: #36752Level: Intermediate1 Hour
  'great explanation and examples'   Read Reviews
The purpose of this course is to provide an in-depth discussion of the caloric testing portion of the VNG/ENG test battery. Content will include descriptions of testing procedures, analysis and interpretation of results.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $99/yr

Learn More

Utilization of the ICS Impulse for Oculomotor Assessment in Videonystagmography
Presented by Alida Naude, PhD, AAC, Kayla van Rie, BA
Recorded Webinar
Natus

Presenters

Alida Naude, PhD, AACKayla van Rie, BA
Course: #33756Level: Intermediate1 Hour
  'Very comprehensive information, explained in an easy understandable manner'   Read Reviews
This presentation describes the use of the ICS Impulse for the assessment of the oculomotor pathway in patients with vestibular pathology. Specific attention will be given regarding which tests analyze similar neurological pathways. The use of a different protocol using the ICS goggles compared to using the traditional VNG protocol will be explored.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $99/yr

Learn More

Addressing Fall Risk: PT, OT, and Audiology Assessment and Intervention, presented in partnership with Salus University
Presented by Bre Myers, AuD, PhD, Helena Esmonde, PT, DPT, NCS, Anna Grasso, OTD
Recorded Webinar
AudiologyOnline

Presenters

Bre Myers, AuD, PhDHelena Esmonde, PT, DPT, NCSAnna Grasso, OTD
Course: #38144Level: Intermediate3 Hours
  'Just great to be more aware of this topic and how we can work with other professionals'   Read Reviews
Multidisciplinary assessment and intervention of individuals at risk of falls is crucial in identifying functional and diagnostic factors as well as effective rehabilitation and prevention of future falls. This series identifies areas of collaboration and supportive information-sharing strategies between professions who commonly see individuals who fall and are likely to be injured due to a fall.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $99/yr

Learn More

Contemporary Concepts in Pediatric Vestibular Assessment and Management, presented in partnership with Seminars in Hearing
Presented by Sharon Cushing, MD, FRCSC, Katheryn Bachmann, PhD, Violette Lavender, AuD, Jennifer B. Christy, PhD, PT, Steven M. Doettl, AuD, PhD, Devin L. McCaslin, PhD, Kristen L. Janky, PhD, Amanda I. Rodriguez, PhD, AuD
Recorded Webinar
AudiologyOnline

Presenters

Sharon Cushing, MD, FRCSCKatheryn Bachmann, PhDViolette Lavender, AuDJennifer B. Christy, PhD, PTSteven M. Doettl, AuD, PhDDevin L. McCaslin, PhDKristen L. Janky, PhDAmanda I. Rodriguez, PhD, AuD
Course: #35586Level: Intermediate5 Hours
  'This course consists of 5 presentations by numerous excellent presenters and adapted from a Seminars in Hearing issue centered about the same topic'   Read Reviews
This 5-part webinar series is focused on the growing evidence of the need for pediatric vestibular evaluation, as well as the availability of successful treatment options for children. Guest editors, Dr. Devin McCaslin and Dr. Jennifer Christy along with a team of leading experts will present on select articles from a recent issue of the journal Seminars in Hearing (Issue 03 · Volume 39 · 2018).

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $99/yr

Learn More

Our site uses cookies to improve your experience. By using our site, you agree to our Privacy Policy.