Skip to main content

Comparison of cervical and ocular vestibular-evoked myogenic potential responses between tone burst versus chirp stimulation



To compare the effectiveness of chirp and tone burst stimuli in oVEMP and cVEMP testing for healthy adults


This study was conducted in 56 healthy volunteers (112 ears). Ocular and cervical VEMP (oVEMP, cVEMP) tests were performed for each participant using tone burst and chirp stimuli. VEMP response rates, latency of each peak (p1–n1, n1–p1), peak to peak amplitude (p1–n1 amplitude and n1–p1 amplitude), and rectified amplitudes were measured and compared between these two different stimuli.


VEMP response rates with chirp stimuli are higher than the tone burst stimuli for both cVEMP and oVEMP tests (The difference was statistically significant for oVEMP, p = 0.001). Chirp stimuli have higher p1n1 amplitude and rectified amplitude and shorter p1and n1 latency then tone burst stimuli for cVEMP (p = 0.015, p = 0.007, p < 0.001, p < 0.001, respectively). Chirp stimuli also have higher n1p1 amplitude and shorter n1and p1 latency then tone burst stimuli for oVEMP (p = 0.006, p < 0.001, p < 0.001, respectively).


The present findings show that the chirp stimulus triggers earlier VEMP responses with higher amplitudes than the tone burst stimulus during cVEMP and oVEMP testing. VEMP response rate with chirp stimulus is also higher than the tone burst. Therefore chirp stimulus can be used in VEMP testing as effectively as, if not more than, tone burst stimulus in clinical practice.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2


  1. Colebatch JG, Halmagyi GM (1992) Vestibular evoked potentials in human neck muscles before and after unilateral vestibular deafferentation. Neurology 42(8):1635–1636

    CAS  Article  Google Scholar 

  2. Murofushi T, Curthoys IS (1997) Physiological and anatomical study of click-sensitive primary vestibular afferents in the guinea pig. Acta Otolaryngol 117(1):66–72

    CAS  Article  Google Scholar 

  3. Zhou G, Cox LC (2004) Vestibular evoked myogenic potentials: history and overview. Am J Audiol 13(2):135–143

    Article  Google Scholar 

  4. Todd NP et al (2007) Ocular vestibular evoked myogenic potentials (OVEMPs) produced by air- and bone-conducted sound. Clin Neurophysiol 118(2):381–390

    Article  Google Scholar 

  5. Rosengren SM, McAngus Todd NP, Colebatch JG (2005) Colebatch, vestibular-evoked extraocular potentials produced by stimulation with bone-conducted sound. Clin Neurophysiol 116(8):1938–1948

    CAS  Article  Google Scholar 

  6. Curthoys IS et al (2011) The ocular vestibular-evoked myogenic potential to air-conducted sound; probable superior vestibular nerve origin. Clin Neurophysiol 122(3):611–616

    Article  Google Scholar 

  7. Rosengren SM, Govender S, Colebatch JG (2011) Ocular and cervical vestibular evoked myogenic potentials produced by air- and bone-conducted stimuli: comparative properties and effects of age. Clin Neurophysiol 122(11):2282–2289

    Article  Google Scholar 

  8. Kantner C et al (2014) The effects of rise/fall time and plateau time on ocular vestibular evoked myogenic potentials. Eur Arch Otorhinolaryngol 271(9):2401–2407

    Article  Google Scholar 

  9. Welgampola MS, Colebatch JG (2005) Characteristics and clinical applications of vestibular-evoked myogenic potentials. Neurology 64(10):1682–1688

    Article  Google Scholar 

  10. Wang BC et al (2014) Comparison of chirp versus click and tone pip stimulation for cervical vestibular evoked myogenic potentials. Eur Arch Otorhinolaryngol 271(12):3139–3146

    Article  Google Scholar 

  11. Ozgur A et al (2015) Comparison of tone burst, click and chirp stimulation in vestibular evoked myogenic potential testing in healthy people. J Int Adv Otol 11(1):33–35

    Article  Google Scholar 

  12. Akkuzu G, Akkuzu B, Ozluoglu LN (2006) Vestibular evoked myogenic potentials in benign paroxysmal positional vertigo and Meniere’s disease. Eur Arch Otorhinolaryngol 263(6):510–517

    Article  Google Scholar 

  13. Streubel SO et al (2001) Vestibular-evoked myogenic potentials in the diagnosis of superior canal dehiscence syndrome. Acta Otolaryngol Suppl 545:41–49

    CAS  Article  Google Scholar 

  14. Murofushi T, Matsuzaki M, Mizuno M (1998) Vestibular evoked myogenic potentials in patients with acoustic neuromas. Arch Otolaryngol Head Neck Surg 124(5):509–512

    CAS  Article  Google Scholar 

  15. Khwaja Moinudeen AV (2020) Comparison of 500 Hz tonebursts and 500Hz octave chirps for cervical vestibular evoked potentials. Int J Sci Res Publ 10(3):332–335

    Google Scholar 

  16. Banu Bas KK, Er S, Ozdek A, Korkmaz MH (2020) Is chirp more effective than click and tone-burst during oVEMP test? Ann Med Res 27(3):819–824

    Article  Google Scholar 

  17. Walther LE, Cebulla M (2016) Band limited chirp stimulation in vestibular evoked myogenic potentials. Eur Arch Otorhinolaryngol 273(10):2983–2991

    Article  Google Scholar 

  18. Ochi K, Ohashi T, Nishino H (2001) Variance of vestibular-evoked myogenic potentials. Laryngoscope 111(3):522–527

    CAS  Article  Google Scholar 

  19. Lee KJ et al (2008) The usefulness of rectified VEMP. Clin Exp Otorhinolaryngol 1(3):143–147

    Article  Google Scholar 

  20. Kim KW et al (2013) Capacity of rectified vestibular evoked myogenic potential in correcting asymmetric muscle contraction power. Clin Exp Otorhinolaryngol 6(4):209–213

    Article  Google Scholar 

  21. Colebatch JG, Halmagyi GM, Skuse NF (1994) Myogenic potentials generated by a click-evoked vestibulocollic reflex. J Neurol Neurosurg Psychiatry 57(2):190–197

    CAS  Article  Google Scholar 

Download references


No funding.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Canset Aydın.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Aydın, C., Önay, Ö., Tezcan, E.İ. et al. Comparison of cervical and ocular vestibular-evoked myogenic potential responses between tone burst versus chirp stimulation. Eur Arch Otorhinolaryngol 279, 2339–2343 (2022).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • cVEMP
  • oVEMP
  • Vestibular test
  • Chirp
  • Tone burst