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Auris Nasus Larynx. 2017 Dec;44(6):648-654. doi: 10.1016/j.anl.2016.12.003. Epub 2017 Jan 8.

Role of video-head impulse test in lateralization of vestibulopathy: Comparative study with caloric test.

Author information

1
Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
2
Department of Otorhinolaryngology, Dongguk University Ilsan Hospital, Goyang, South Korea.
3
Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
4
Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea. Electronic address: jwkoo99@snu.ac.kr.

Abstract

OBJECTIVE:

To evaluate the lateralization value of video head-impulse test (vHIT) for the diagnosis of vestibulopathy and to analyze cases showing dissociated results with caloric test.

METHODS:

In total, 19 healthy volunteers and 92 dizzy patients who underwent both a caloric test and a vHIT were enrolled. Patients were divided into two groups depending on their fluctuating pattern of vertigo. The vestibulo-ocular reflex (VOR) gain and gain asymmetry (GA) of a vHIT as well as unilateral weakness (UW) and the sum of the slow-phase velocities (SPVs) of warm and cold irrigation of the same side were compared. A cutoff value of VOR gain of a vHIT was also calculated using a receiver-operating characteristic curve.

RESULTS:

A VOR gain in an affected ear and GA of a vHIT showed a statistically significant correlation with UW in a caloric test. The cutoff value of a vHIT was determined to be 0.875, derived under the assumption that UW of a caloric test ≤25% is normal. However, the parameters of the two tests were dissociated in 18%.

CONCLUSION:

A VOR gain of vHIT is a valuable objective parameter with a lateralization value determining vestibular hypofunction. However, considering substantial dissociation between a vHIT and a caloric test, these tests can be complementary tools for the lateralization of vestibular impairment for the comprehensive evaluation of patients' VOR.

KEYWORDS:

Caloric test; ROC curve; Vertigo; Video head impulse test

PMID:
28077250
DOI:
10.1016/j.anl.2016.12.003
[Indexed for MEDLINE]

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