Effects of Occlusion and Conductive Hearing Loss on Bone-Conducted cVEMP

Objective: To evaluate the effects of conductive hearing loss and occlusion on bone-conducted cervical vestibular evoked myogenic potentials (cVEMPs). Study Design: Prospective cohort study conducted in the year 2018. The right ear of each volunteer was evaluated under 3 conditions by using bone-conducted cVEMPs: normal (open external auditory canal), occluded (conductive hearing loss with occlusion effect), and closed (conductive hearing loss without the occlusion effect). Setting: Single academic center. Subjects and Methods: The study comprised 30 healthy volunteers aged 20 to 35 years (16 women, 14 men). All had normal hearing and no vestibular or auditory pathologies. The thresholds and amplitudes of cVEMP responses were recorded for the 3 conditions. The results of each condition for a particular participant were compared. Results: As compared with the open condition, the conductive condition increased thresholds by 2.8 dB (P =.01), and the occluded condition decreased thresholds by 3.8 dB (P =.008). The amplitude in the occluded condition was larger than the normal condition and the conductive condition (mean difference: 20.64 [P =.009] and 31.76 [P <.001], respectively) Conclusion: The occlusion effect is present in cVEMP responses. The mechanism is not due to the conductive hearing loss induced. Clinical implications include potentially altering vestibular function with sealed hearing aids and in the surgically modified ears (ie, obliterated ears and open cavity mastoidectomy).