A new method to analyze the subjective visual vertical in patients with bilateral vestibular dysfunction

Abstract

OBJECTIVE:The aim of this study was to assess the subjective visual vertical in patients with bilateral vestibular dysfunction and to propose a new method to analyze subjective visual vertical data in these patients.METHODS:Static subjective visual vertical tests were performed in 40 subjects split into two groups. Group A consisted of 20 healthy volunteers, and Group B consisted of 20 patients with bilateral vestibular dysfunction. Each patient performed six measurements of the subjective visual vertical test, and the mean values were calculated and analyzed.RESULTS:Analyses of the numerical values of subjective visual vertical deviations (the conventional method of analysis) showed that the mean deviation was 0.326±1.13° in Group A and 0.301±1.87° in Group B. However, by analyzing the absolute values of the subjective visual vertical (the new method of analysis proposed), the mean deviation became 1.35±0.48° in Group A and 2.152±0.93° in Group B. The difference in subjective visual vertical deviations between groups was statistically significant (p<0.05) only when the absolute values and the range of deviations were considered.CONCLUSION:An analysis of the absolute values of the subjective visual vertical more accurately reflected the visual vertical misperception in patients with bilateral vestibular dysfunction.

Stimulation from Cochlear Implant Electrodes Assists with Recovery from Asymmetric Perceptual Tilt: Evidence from the Subjective Visual Vertical Test

“…When compared to the arithmetic mean of SVV trials, the mean of absolute SVV values more accurately reflects the perceptual abnormalities of patients with bilateral vestibular dysfunction (Funabashi et al, 2012 ). We expected to find abnormalities in SVV given that vestibular—specifically otolithic—dysfunction is common in children with CIs (Cushing et al, 2013 ).…”

“…Transient abnormalities in the SVV have also been reported in adults with sudden unilateral SNHL (Ogawa et al, 2012 ). Patients with bilateral vestibular loss score similarly to control groups (Tabak et al, 1997 ; Guerraz et al, 2001 ), although a closer examination of their SVV reveals greater inter-trial variability (Funabashi et al, 2012 ). Much of the research to date has focused on visual vertical perception in adults, yet Brodsky et al ( 2016 ) have recently demonstrated that the evaluation of SVV in pediatric patients is, in fact, feasible.…”

Bilateral Vestibular Hypofunction: Challenges in Establishing the Diagnosis in Adults

“…It does not discriminate very well between vestibular disorders and other causes of imbalance such as cerebellar ataxia [12]. The accuracy of subjective visual vertical testing for BVH has still to be refined [162]. Many other tests can also be used in the diagnostic process if necessary: audiometry, measuring blood pressure, measuring orthostatic hypotension, blood tests (including autoantibodies, complement factors, folate, vitamin B 12 , renal function, thyroid function, glucose, genetics, etc.…”

Nuevo método para evaluar el Test Subjetivo Vertical

“…La sensibilidad de la prueba del balde es de 89% si se evalúa monocularmente o 90% si es binocular, de repetirse la prueba 10 veces la sensibilidad aumenta a 92% para detectar alteraciones utriculares periféricas 12 . SVV ha sido utilizado ampliamente para estudiar alteraciones del equilibrio, en diversos contextos, con gran impacto en la toma de decisiones y manejo de pacientes [24][25][26][27][28][29][30][31][32] .…”