Background and ObjectivesZZThe bedside head impulse test (bHIT) in bare eyes often overlooks possible vestibular losses by missing the corrective saccade. This is why it is necessary to compare bHIT against video head impulse test (vHIT), which is more accurate in identifying vestibular losses than the bedside test. Subjects and MethodZZA total of 51 vHIT positive ears underwent the study, and out of those, 47 were diagnosed with dizziness. bHIT and vHIT were performed for patients, and the occurrence rate of overt saccade (OS) was calculated. ResultsZZAmong the 51 vHIT positive ears, 33 (64.7%) were bHIT positive ears and 18 ears (35.3%) were bHIT negative. Patterns of positive vHIT were classified as A: no corrective saccade, B: covert saccade (CS) only, C: OS only, and D: CS with OS (CS+OS), which were 45 out of 51 ears (88%). The occurrence rate of OS was higher in the bHIT positive group than in the bHIT negative group (p=0.05), and higher in the CS negative group (CS-) than in the CS positive group (CS+) (p<0.001). ConclusionZZPossible causes of false negative results of bHIT are seen as following: the absence of corrective (covert and overt) saccade, the occurrence of CS only, and missing the OS during the bHIT (probably due to low occurrence rate of OS). The occurrence of CS should be considered as an important factor in false negative bHIT when lowering the occurrence rate of OS.
There were few recent study concern about usefulness of cochlear hydrops analysis masking procedure (CHAMP) in progression of Ménièreʼs disease. The purpose of this study is to analyze changes in the CHAMP as advancement of Ménièreʼs disease. Methods: We studied 19 cases of 'Definite' group of Ménièreʼs disease. We assumed progression of Ménièreʼs disease would be checked by pure tone threshold by four tone average (4PTA), low tone average (LPTA). We also compared electrocochleography (ECoG), dizziness handicap inventory (DHI), tinnitus handicap inventory (THI) as parameters for progression of Ménièreʼs disease to CHAMP latency delay and amplitude ratio. Chi-square test was used as a statistical method. Results: In the group of patients had abnormal amplitude ratio, ECoG value were not improved, but there was not statistically significant (odds ratio [OR]=5.727, p>0.05). Better DHI and THI score were not necessarily construed as the improvement value in the CHAMP (p>0.05). In amplitude ratio abnormal group, 4PTA was aggravated, but not statistically significant (OR=1.5, p>0.05). In the group of patient had abnormality in both latency delay and amplitude ratio, LPTA was relatively aggravated (OR in latency delay: 2, OR in amplitude ratio: 10); however, reveals no statistically significance between them (p>0.05). Change of ECoG, hearing threshold including 4PTA and LPTA with progression of Ménièreʼs disease were not correlated significantly with latency delay or amplitude ratio of CHAMP. Conclusion:We conclude that CHAMP does not reflect clinical features with progression of Ménièreʼs disease.
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