Sensitivity of caloric test and video head impulse as screening test for chronic vestibular complaints

Mezzalira, Raquel; Bittar, Roseli Saraiva Moreira; Bilécki-Stipsky, Marcia Maria do Carmo; Brugnera, Cibele; Grasel, Signe Schuster

doi:10.6061/clinics/2017(08)03

Cited by 35 publications

(34 citation statements)

References 18 publications

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“…Interpreting vHIT exams is more clear-cut, and detecting new overt or covert saccades in the postoperative period, or drop in the gain of head movement/eye movement to <0.6, should be recognized as vestibular damage. However, the sensitivity of vHIT is a matter for further research and many papers indicate that, among patients with vestibular neuritis or other symptoms suggestive of impairment, a lower percentage have vestibular damage detected by vHIT than by the caloric test (39)(40)(41). The same discrepancy was observed in our study.…”

Section: Discussionsupporting

confidence: 77%

Vestibular Function After Cochlear Implantation in Partial Deafness Treatment

et al. 2021

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Introduction: Cochlear implantation is a fully accepted method of treating individuals with profound hearing loss. Since the indications for cochlear implantation have broadened and include patients with low-frequency residual hearing, single-sided deafness, or an already implanted ear (meaning bilateral cochlear implantation), the emphasis now needs to be on vestibular protection.Materials and Methods: The research group was made up of 107 patients operated on in the otorhinolaryngosurgery department: 59 females and 48 males, aged 10.4–80.2 years (M = 44.4; SD = 18.4) with hearing loss lasting from 1.4 to 56 years (M = 22.7; SD = 13.5). The patients underwent cVEMP, oVEMP, a caloric test, and vHIT assessment preoperatively, and, postoperatively, cVEMP and oVEMP at 1–3 months and a caloric test and vHIT at 4–6 months.Results: After cochlear implantation, there was postoperative loss of cVEMP in 19.2% of the patients, oVEMP in 17.4%, reduction of caloric response in 11.6%, and postoperative destruction of the lateral, anterior, and posterior semicircular canal as measured with vHIT in 7.1, 3.9, and 4% respectively.Conclusions: Hearing preservation techniques in cochlear implantation are connected with vestibular protection, but the risk of vestibular damage in never totally eliminated. The vestibular preservation is associated with hearing preservation and the relation is statistically significant. Informed consent for cochlear implantation must include information about possible vestibular damage. Since the risk of vestibular damage is appreciable, preoperative otoneurological diagnostics need to be conducted in the following situations: qualification for a second implant, after otosurgery (especially if the opposite ear is to be implanted), having a history of vestibular complaints, and when there are no strict audiological or anatomical indications on which side to operate.

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Section: Discussionsupporting

confidence: 77%

Vestibular Function After Cochlear Implantation in Partial Deafness Treatment

et al. 2021

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“…Our experience with dizziness at our clinical practice is that the sensitivity in detecting vestibular impairment between the CT and vHIT was 3:1 15. Our hypothesis was that in contrast to our observations with chronic vestibular diseases vHIT could be proportionally more sensitive in specific cases, like CI recipients'.…”

Section: Discussioncontrasting

confidence: 54%

“…These cells are connected to regular afferent neural fibres. Our previous experience with patients suffering from dizziness in our neurotology practice suggests that the sensitivity of the CT and vHIT in detecting vestibular impairment was at a 3:1 proportion 15.…”

Section: Introductionmentioning

confidence: 95%

Caloric test and video head impulse test sensitivity as vestibular impairment predictors before cochlear implant surgery

Bittar¹,

Sato²,

Silva-Ribeiro³

et al. 2019

Clinics

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OBJECTIVES: Currently, cochlear implant procedures are becoming increasingly broad and have greatly expanded. Bilateral cochlear implants and cochlear implants are more frequently applied in children. Our hypothesis is that the video head impulse test may be more sensitive than the caloric test in detecting abnormal vestibular function before cochlear implant surgery. The objective of this study was to compare the video head impulse test and caloric test results of patients selected for cochlear implant procedures before surgery. METHODS: The patients selected for cochlear implant surgery were submitted to a bithermal caloric test and video head impulse test. RESULTS: By comparing angular slow phase velocity values below 5° in the bithermal caloric test (hypofunction) and video head impulse test with a gain lower than 0.8, we identified 37 (64.9%) patients with vestibular hypofunction or canal paresis and 21 (36.8%) patients with abnormal video head impulse test gain before the cochlear implant procedure. Of the 37 patients with caloric test vestibular hypofunction, 20 (54%) patients exhibited an abnormal gain in the video head impulse test. CONCLUSION: The caloric test is more sensitive than the video head impulse test (Fisher's exact test, p =0.0002) in detecting the impaired ear before cochlear implant delivery. The proportion of caloric test/video head impulse test positive identification of abnormal vestibular function or caloric test/video head impulse test sensitivity was 1.8:1.

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“…Also, the extent of hydrops correlates with the extent of caloric weakness with normal VHIT tests. 7,12,14 Choi et al of 2007 also pointed out the same discrepency. In our study also caloric tests showed better sensitivity compared to VHIT especially in patients with chronic complaints.…”

Section: Discussionmentioning

confidence: 90%

Electronystagmographic analysis of peripheral vertigo

Suresh¹,

Narendran²

2020

Int J Otorhinolaryngol Head Neck Surg

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Background: Examination of the vestibulo-ocular reflex is still the investigation of choice for evaluating the vestibular function to rule out peripheral causes. Aim and objectives were to compare the electronystagmographic changes of all peripheral forms of vertigo and to highlight its significance in the diagnosis and management of the same.Methods: This is a prospective study done after obtaining ethical committee approval in a total of 100 patients attending the ENT OPD at Sri Muthukumaran Medical College Hospital & Research Institute with chief complaints of vertigo. Patients diagnosed with chronic suppurative otitis media, hypertensive patients, h/o seizures, recent cardiac illness or patients on cardiac investigations, psychotic disorders, documented CNS lesions, cervical spondylitis, h/o recent eye/ ear surgery are excluded from this study. ENG analysis includes occulomotor testing, positional testing and caloric stimulation. Evaluation of gait and balance is done followed by maneuver induced vertigo testing (dix hallpike and fistula test) along with PTA. Statistical analysis was done using independent sample t test and chi square test to check the hypothesis using statistical package for social studies SPSS version 17. Results: The observations of ENG like spontaneous nystagmus and bi-thermal caloric test responses are represented on a claussens butterfly chart and the corresponding bar codes were obtained. The inferences for different forms of vertigo were studied.Conclusions: ENG is now an accepted routine and basic investigation in the management of all patients suffering from equilibrium disorders. Management consists of diagnosing the underlying pathology and treatment of the same.

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Sensitivity of caloric test and video head impulse as screening test for chronic vestibular complaints

Cited by 35 publications

References 18 publications

Vestibular Function After Cochlear Implantation in Partial Deafness Treatment

Vestibular Function After Cochlear Implantation in Partial Deafness Treatment

Caloric test and video head impulse test sensitivity as vestibular impairment predictors before cochlear implant surgery

Electronystagmographic analysis of peripheral vertigo

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