Video head impulse test and caloric test in definite Ménière’s disease

Limviriyakul, Siriporn; Luangsawang, Chadarthan; Suvansit, Kanokrat; Prakairungthong, Sarun; Thongyai, Kanthong; Atipas, Suvajana

doi:10.1007/s00405-019-05735-8

Cited by 27 publications

(20 citation statements)

References 16 publications

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“…Conversely, 100% of operated patients showed a significant caloric hypofunction, 80% had a severe hypofunction higher than 80%, and six cases had an areflexia. In the literature, CaT is modified in non-operated Menière disease patients in between 53% and 76% of cases with a moderate hypofunction [ 14 , 15 , 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Skull Vibration-Induced Nystagmus Test in a Human Model of Horizontal Canal Plugging

et al. 2021

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Background/Aim: the aim of this study was to assess the skull vibration-induced nystagmus test (SVINT) results and vestibular residual function after horizontal semicircular canal (HSCC) plugging. Methods: In this retrospective chart review performed in a tertiary referral center, 11 patients who underwent unilateral horizontal semicircular canal plugging (uHSCCP) for disabling Menière’s disease (MD) were included. The skull vibration-induced nystagmus (SVIN) slow-phase velocity (SPV) was compared with the results of the caloric test (CaT), video head impulse test (VHIT), and cervical vestibular-evoked myogenic potentials (cVEMP) performed on the same day. Results: Overall, 10 patients had a strong SVIN beating toward the intact side (Horizontal SVIN-SPV: 8.8°/s ± 5.6°/s), 10 had a significant or severe ipsilateral CaT hypofunction, 10 had an ipsilateral horizontal VHIT gain impairment, and 3 had altered cVEMP on the operated side. Five had sensorineural hearing worsening. SVIN-positive results were correlated with CaT and horizontal VHIT (HVHIT) results (p < 0.05) but not with cVEMP. SVIN-SPV was correlated with CaT hypofunction in % (p < 0.05). Comparison of pre- and postoperative CaT % hypofunction showed a significant worsening (p = 0.028). Conclusion: SVINT results in a human model of horizontal canal plugging are well correlated with vestibular tests exploring horizontal canal function, but not with cVEMP. SVINT always showed a strong lesional nystagmus beating away from the lesion side. SVIN acts as a good marker of HSCC function. This surgical technique showed invasiveness regarding horizontal canal vestibular function.

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Section: Discussionmentioning

confidence: 99%

Skull Vibration-Induced Nystagmus Test in a Human Model of Horizontal Canal Plugging

et al. 2021

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“…This most frequent involvement is likely due to the highest abnormal rate in the RCT but does not really indicate a higher chance of an H-SC pathology as indicated by the difference in the abnormal rates (93.75% in the RCT for H-SC and <40% in the vHIT for A-and P-SCs). The results of the RCT and vHIT are often dissociated in MD, so as caloric test and vHIT, reported by other studies (54)(55)(56). Caloric test was represented more sensitive than the vHIT test previously, whereas the caloric test was abnormal only when vestibular dysfunction in RCT was detected at least three consecutive frequencies (34).…”

Section: Discussionmentioning

confidence: 86%

“…Given the fluctuating clinical presentation of MD, the differing results can be ascribed to the predilection for type II hair cell loss in MD ( 54 , 61 ). It has been suggested that type I hair cells and irregular afferent fibers are responsible for the high-frequency response in the vHIT, whereas the type II hair cells and regular fibers are responsible for the low-frequency (caloric) response ( 56 ). Rubin demonstrated the phasic hair cells with irregular fibers were still functioning in advanced stage of MD, which contributed to normal vHIT results in contrast to abnormal low-frequency reflex ( 48 ).…”

Section: Discussionmentioning

confidence: 99%

A New Proposal for Severity Evaluation of Menière's Disease by Using the Evidence From a Comprehensive Battery of Auditory and Vestibular Tests

Huang

Zhou

et al. 2020

Front. Neurol.

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To date, no widely accepted criteria exist to quantify the severity of Menière's disease (MD) by using vestibular tests. This study aimed to compare association of hearing loss and vertigo severity with association of accurate assessments of vestibular function and the vertigo severity. The severity of vertigo was documented by a comprehensive medical history with number of vertigo attacks in the past 6 months and a Dizziness Handicap Inventory (DHI) questionnaire. The involvement of vestibular organs was verified by audio-vestibular tests in 80 definite MD patients. Correlations between DHI scores, number of vertigo attacks in the past 6 months, audio-vestibular function, and the number of involved vestibular end organs were evaluated. We show that there are no significant differences in either severity of vertigo or laboratory results across the degree of hearing loss. Furthermore, the number of involved vestibular end organs was significantly correlated with vestibulo-ocular reflex gain in anterior and posterior canal video head impulse test (vHIT), interaural asymmetry ratio in vestibular-evoked myogenic potentials (VEMPs), and number of vertigo attacks in the past 6 months and DHI score. The vestibulo-ocular reflex gain in the rotatory chair test (RCT) was significantly correlated with the DHI Physical scores and number of involved vestibular end organs at 0.08 Hz. These results indicate that hearing loss is a poor indicator of vertigo severity in MD whereas the number of involved vestibular end organs may serve as an objective measure for MD progress. A battery of vestibular tests targeting different sensor organs is a complementary method for evaluating inner ear deficits and may aid in "grading" the severity of MD.

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“…As demonstrated in Table 2, it has been noticed by previous studies that even though caloric test usually demonstrates an asymmetry toward the affected ear, vHIT parameters are usually preserved in definite MD (22)(23)(24)(25)(26)(27)(28)(29)(30). Some authors tried to evaluate if this discrepancy in the results may be in relation to the duration or the stage of MD but failed to find a significant relationship (25,27,29).…”

Section: Discrepancies Between Caloric Test and Vhit In Meniere's Diseasementioning

confidence: 99%

Usefulness of Video Head Impulse Test Results in the Identification of Meniere's Disease

et al. 2020

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Meniere's disease (MD) is an inner ear disorder inducing tinnitus, aural fullness, sensorineural hearing loss, and vertigo episodes. In the past few years, efforts have been made to develop objective measures able to distinguish MD from other pathologies. Indeed, some authors investigated electrophysiological measures, such as electrocochleography and vestibular evoked myogenic potentials or imaging techniques. More recently, the video head impulse test (vHIT) was developed to assess the vestibulo-ocular reflex (VOR). In the last few years, authors aimed at identifying how vHIT may help to identify MD. The objective of this manuscript is to review the different vHIT results in MD patients. We will discuss the usefulness of these findings in the identification of MD, how these results may be explained by pathophysiological mechanisms associated with MD, and finally provide directions for future studies.

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Video head impulse test and caloric test in definite Ménière’s disease

Cited by 27 publications

References 16 publications

Skull Vibration-Induced Nystagmus Test in a Human Model of Horizontal Canal Plugging

Skull Vibration-Induced Nystagmus Test in a Human Model of Horizontal Canal Plugging

A New Proposal for Severity Evaluation of Menière's Disease by Using the Evidence From a Comprehensive Battery of Auditory and Vestibular Tests

Usefulness of Video Head Impulse Test Results in the Identification of Meniere's Disease

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