Clinical superiority of belly-tendon montage over others for recording air-conducted ocular vestibular evoked myogenic potential

Ocular vestibular-evoked myogenic potentials (oVEMP) using the belly-tendon (BT) electrode montage have well-documented superiority over other montages in healthy adults. However, little is known about its clinical superiority, especially in disorders with rock-bottom response rates, like Auditory Neuropathy Spectrum Disorders (ANSD). Therefore, this study aimed to compare the response parameters of oVEMP to 500 Hz tone bursts from BT, infra-orbital (IO), chin-referenced (CR), and sternum-referenced (SR) electrode montages, between 30 adults with ANSD and 30 age-matched controls. Similar to the well-documented superior response characteristics in healthy adults, the BT montage showed superior response characteristics in ANSD, too. Additionally, the BT montage showed better inter-group discriminability than the IO montage. With a higher response rate, larger peak-to-peak amplitude, and better potency in discriminating a pathological condition from the controls, BT montage affirms clinical superiority over the other electrode montages for recording oVEMPs.