Cervical vestibular evoked myogenic potentials (cVEMP) and posterior canal video head impulse testing (PC-vHIT) are conventionally treated as measures of one inferior vestibular unit. We quantified how often they disagree, and whether this varies with age.
✦ The floor
Discussion
Signed responses from readers of the wire.
Audiologists should interpret cervical VEMP and posterior canal vHIT as independent measures of distinct vestibular pathways rather than redundant checks of the same inferior vestibular nerve unit; discordant results between the two tests are normal and do not necessarily indicate test error.
Clarifying that cVEMP and posterior canal vHIT assess functionally separate pathways has direct implications for how clinicians interpret vestibular test batteries and diagnose vestibular disorders.
- 01Study analysed 1,770 unselected ears — a large, clinically diverse dataset.
- 02Cervical VEMP (cVEMP) and posterior canal vHIT showed significant functional dissociation.
- 03Results challenge the assumption that both tests reflect a single inferior vestibular unit.
- 04Discordant cVEMP/vHIT results should be interpreted as clinically meaningful, not artifactual.
- 05Published in Laryngoscope (DOI 10.1002/lary.70912).
Cervical VEMP and posterior canal vHIT measure functionally dissociated vestibular pathways, not a single inferior vestibular unit.
studysupportedDiscordance between cVEMP and posterior canal vHIT is common in unselected clinical ears.
studysupported- PMID
- 42749461
- DOI
- 10.1002/lary.70912.
- Journal
- Laryngoscope
- Publication type
- research_article
- Evidence level
- 2b
- Sample size
- 1,770
- Population
- 1,770 unselected ears from patients undergoing vestibular testing
- Intervention
- Cervical VEMP and posterior canal video Head Impulse Test (vHIT)
- Comparator
- Comparison of cVEMP and posterior canal vHIT results within the same ears
Primary outcomes
Rate of functional dissociation between cVEMP and posterior canal vHIT; Concordance/discordance patterns across the test population