Usefulness of Cervical Vestibular-Evoked Myogenic Potentials for Diagnosing Patients With Superior Canal Dehiscence Syndrome: A Meta-Analysis

Otology & Neurotology

Kim, D. H., Kim, S. W., et al. (2022).

Otology & Neurotology, 43(2), 146-152.

This systematic review and meta-analysis investigates the diagnostic accuracy of cervical vestibular-evoked myogenic potential for detecting superior canal dehiscence syndrome in individuals compared to computed tomography (CT) imaging and surgical findings.

National Research Foundation of Korea

From database inception to July 2021

Observational studies that provide sensitivity and specificity data. Excludes case reports and review articles.

9

Cervical vestibular-evoked myogenic potential (cVEMP) demonstrates good diagnostic accuracy for identifying patients with superior canal dehiscence syndrome (SCDS). Meta-analysis of 9 studies found a pooled sensitivity of 0.8278 (95% CI=0.7517 to 0.8842) and specificity of 0.8824 (95% CI=0.7859 to 0.9387); however, due to the inclusion of different VEMP thresholds (≤65, 70, 75, 80, and 85), the authors found a high degree of heterogeneity across studies. Subgroup analysis revealed no significant difference in the sensitivity or specificity of each VEMP threshold; however, a cVEMP threshold of 75 showed optimal sensitivity (0.7455) and specificity (0.9526) compared to other cVEMP thresholds. When comparing cVEMP to computed tomography imaging (CT) or surgical findings, the authors detected no significant differences in sensitivity (CT=0.8166; surgical findings=0.8453) or specificity (CT=0.8849; surgical findings=0.8762) between the reference groups. Limitations to this review such as the small number of available studies, heterogeneity between variability in study implementation factors (e.g., operators, devices used), and low quality of evidence indicate the need for additional research. The authors conclude that the cVEMP is an appropriate tool for identifying SCDS in individuals.