Caloric Test in Low-tone Sensorineural Hearing Loss

Abstract

Acute low-tone sensorineural hearing loss (ALHL) is generally has a relatively good prognosis. We have often found in long-term following-up, however, that ALHL relapses, recurs or develops into Meniere's disease. Diagnostic criteria of the Acute Altitude Deafness Research Group of the Ministry of Health, Labor, and Welfare of Japan, define ALHL as low-tone-disorder sensorineural hearing loss without vertigo in which cochlear symptoms -ear fullness, tinnitus, and deafness- develop suddenly. Over the last five years, we have treated 31 cases of ALHL, in about half of which neurotological examination showed potential peripheral vestibular dysfunction on testing positional nystagmus (a) with closed eyes and (b) in a dark room with open eyes, and by finding laterality in the peripheral labyrinth system on caloric test. These cases show high canal paresis -a maximum slow- phase eye velocity of caloric nystagmus exceeding 60%. These results, taken together, suggest that derangement extends to the peripheral labyrinth system in patients with ALHL.

Meta-Analysis Comparing Steroids and Diuretics in the Treatment of Acute Low-Tone Sensorineural Hearing Loss

“…McCabe11 recognizes that patients with sensorineural hearing loss have an autoimmune response based on diagnostic studies and patient response to immunosuppressant agents such as cortisone. A study12 has shown that although ALHL patients do not have vertigo, it is not uncommon to have abnormal vestibular function. The water caloric test suggests that some patients with early-stage ALHL have different degrees of vestibular dysfunction.…”