Comparison of electrode montages for ocular Vestibular Evoked Myogenic Potential (oVEMP) using air-conducted tone burst stimulation: Is there an optimal configuration?

OBJECTIVE: To compare three electrode montages - infraorbital (standard), chin and belly-tendon - for ocular Vestibular Evoked Myogenic Potential (oVEMP), using air-conducted 500 Hz tone burst stimulation in health adults. METHODS: An observational cross-sectional study was conducted in 50 healthy volunteers (100 ears) aged 22‒55. oVEMP was recorded using three randomized electrode montages in all volunteers. N1 and P1 latencies, peak-to-peak amplitudes and asymmetry ratios were analyzed. RESULTS: Belly-tendon montage was associated with shorter N1 and P1 latencies compared to both infraorbital and chin montages (p < 0.05) and no significant differences in peak-to-peak amplitudes or asymmetry ratios were observed. No ear side or sex differences were found, while a significant negative correlation between age and interamplitude was noted. CONCLUSIONS: While the belly-tendon montage demonstrated shorter N1 and P1 latencies, all three configurations provided comparable amplitude and asymmetry ratio values. These finds suggest that electrode montage choice may prioritize patient comfort, examiner experience and anatomical characteristics.