# Validation of NB CE-Chirps in the Diagnosis of Superior Semicircular Canal Dehiscence Syndrome

## TL;DR

This study shows that NB CE-Chirps at 500 Hz are effective for diagnosing Superior Semicircular Canal Dehiscence Syndrome, with potential advantages over traditional Tone Bursts.

## Contribution

The study validates NB CE-Chirps as a diagnostic tool for SSCDS and compares their effectiveness to Tone Bursts.

## Key findings

- NB CE-Chirps at 500 Hz significantly differentiate affected from healthy ears in cVEMPs and oVEMPs.
- SSCDS ears showed lower intensity thresholds with NB CE-Chirps than with Tone Bursts at 500 Hz.
- Stimulation at 4000 Hz with both stimuli shows promise for screening SSCDS with reduced sound exposure.

## Abstract

Background/Objectives: The aim of this study was to assess NB CE-Chirps for diagnosing Superior Semicircular Canal Dehiscence Syndrome (SSCDS) with cervical and ocular vestibular evoked myogenic potentials (cVEMPs and oVEMPs), and to compare them with Tone Bursts (TBs). Methods: Nine subjects diagnosed with SSCDS were included (four men/five women, median = 61 years, range = 31–79 years). Intensity thresholds at 500 Hz were investigated with both stimuli. A response was also sought when NB CE-Chirps and TBs were delivered at 4000 Hz for c and oVEMPs. Results: Both 500 Hz TBs and 500 Hz NB CE-Chirps significantly differentiated affected ears from healthy ears for cVEMPs (p < 10−3 in both cases) and oVEMPs (p < 10−3 in both cases). Furthermore, we observed significantly lower intensity thresholds in SSCDS ears with 500 Hz NB CE-Chirps than with 500 Hz TBs for both cVEMPs (p < 10−3) and oVEMPs (p = 0.036). Regarding the response rate at 4000 Hz, only TBs consistently showed a response in 100% of cases for the affected ears, with no response in healthy ears for both cVEMPs and oVEMPs. However, there was no significant difference between the response rates obtained at 4000 Hz using TBs and NB CE-Chirps in affected ears (p = 1.000 for cVEMPs and p = 1.000 for oVEMPs). Conclusions: Searching for intensity thresholds with NB CE-Chirps 500 Hz in cVEMPs and oVEMPs is an effective method for diagnosing SSCDS, likely with better frequency specificity than with 500 Hz TBs. Stimulation at 4000 Hz with both TBs and NB CE-Chirps appears to be a promising test for easily screening this syndrome, reducing both sound exposure and the duration of the examination. The possibility to reduce rise time in 4000 Hz TBs may favor this stimulus over NB CE-Chirps at this frequency for this disease. These results should be confirmed in larger cohorts including patients with more severe forms.