Discrepancies between video head impulse and caloric tests in patients with enlarged vestibular aqueduct

Introduction: The inner ear vestibular system is essential to balance function. Although hearing loss is well-described and quite common following meningitis, the literature evaluating vestibular function following meningitis is very limited. In particular, information on results of contemporary vestibular function tests, e.g., the video head impulse test (VHIT), is scarce. Using contemporary vestibular function tests, this study examines the vestibular function of patients with profound hearing loss (HL) after meningitis. Methods: Review of the literature and retrospective controlled study. Patients: Twenty-one consecutive patients with profound HL after meningitis (cochlear implant candidates) matched with 20 patients with profound HL of unknown etiology and examined during the period 2013-2018. Outcome Measure: Vestibular function loss, as evaluated with VHIT vestibulo-ocular reflex (VOR) gain, eye movement saccades, and cervical vestibular-evoked myogenic potentials (cVEMPs). The results of these tests were correlated to inner ear imaging findings (MRI/CT) and the level of hearing loss. Results: Mean VHIT gain was 0.48 in the meningitis group compared to 0.86 in the control group (p < 0.01). Saccades were present in 21 ears (62%) in the meningitis group compared to six ears (15%) among the controls (p < 0.01). cVEMP responses were present on five ears (18%) in the meningitis group and 25 ears (66%) in the control group (p < 0.01). Discussion: Postmeningitic hearing loss is associated with poor vestibular function, as evaluated by VHIT, saccades, and cVEMP. Loss of vestibular function correlates with the degree of hearing loss and inner ear imaging findings, although not in all cases. Vestibular function should be examined in patients surviving meningitis with hearing loss in order to individualize rehabilitation and improve balance outcome.

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“…Complete loss of VOR function was defined as a gain value <0. 25. Gain values below zero were defined as 0.…”

Section: Vestibular Testingmentioning

confidence: 99%

Functional Loss After Meningitis—Evaluation of Vestibular Function in Patients With Postmeningitic Hearing Loss

et al. 2020

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“…This pattern has been found in 20% of patients with dizziness [8] but is more frequent in patients with M eni ere's disease in which it is hypothesized to be due to hydropic distention of the membranous labyrinth in the LSC [11] and ampulla [12]. It has also been reported to be a frequent finding in patients with enlarged vestibular aqueduct [13]. We have shown in our case that this could be a possible explanation based on the MRI findings that were similar to those reported by others [7].…”

Section: Discussionmentioning

confidence: 95%

Dissociated responses to caloric and head impulse stimulation in a case of isolated vestibule-lateral semicircular canal dysplasia

Wegmann-Vicuña

Garaycochea

Domínguez-Echavarri

et al. 2017

Acta Oto-Laryngologica Case Reports

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“…Detailed processes of the caloric tests and vHITs were described in our previous study. 11) A conventional bi-thermal caloric test was performed with a binocular video oculography system (SLMed, Seoul, Korea) with the patient in a supine position with 30° of head flexion. Each ear canal was stimulated for 30 seconds separately with water at temperatures of 30°C and 44°C, with a pause of 5 minutes between the two.…”

Section: Caloric Tests and Vhitsmentioning

confidence: 99%

Long-Term Changes in Video Head Impulse and Caloric Tests in Patients with Unilateral Vestibular Neuritis

Lee¹,

Kim²,

Jung³

2019

Korean J Otorhinolaryngol-Head Neck Surg

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Background and Objectives Video head impulse tests (vHITs) and caloric tests are widely used to assess the loss of vestibular function in acute vestibular neuritis. Although previous studies have reported on the results of each test, longitudinal comparison of these tests is rare. In the present study, vHITs and caloric tests were performed in patients with unilateral vestibular neuritis during the acute phase and after a long follow-up period (＞6 months). The goal of this study was to evaluate the changes in vHIT and caloric test results and to analyze the relationships between them. Subjects and Method Between September 2013 and December 2015, charts from 13 patients with unilateral vestibular neuritis were retrospectively reviewed. Among the 13 patients, caloric tests and vHITs were performed in 9 and 10 patients, respectively. Results of the vHITs and caloric tests were analyzed and the changes were compared. Results During the acute phase of vestibular neuritis, the results of the caloric test showed an increase in canal paresis (CP), and the results of the vHIT showed a decrease in horizontal gain. Although subjective symptoms improved in all patients after a long follow-up period (mean: 13.9 months), the occurrence of CP determined from the caloric test was not significantly changed (p=0.889). On the other hand, the mean horizontal gain of the vHIT had improved significantly (p＜0.05). Conclusion While CP determined from the caloric test did not change after a long follow-up period, the decreased horizontal gain in the vHIT was significantly recovered in patients with unilateral vestibular neuritis.

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Discrepancies between video head impulse and caloric tests in patients with enlarged vestibular aqueduct

Abstract: 4. Laryngoscope, 127:921-926, 2017.

Cited by 38 publications

References 31 publications

Functional Loss After Meningitis—Evaluation of Vestibular Function in Patients With Postmeningitic Hearing Loss

Functional Loss After Meningitis—Evaluation of Vestibular Function in Patients With Postmeningitic Hearing Loss

Dissociated responses to caloric and head impulse stimulation in a case of isolated vestibule-lateral semicircular canal dysplasia

Long-Term Changes in Video Head Impulse and Caloric Tests in Patients with Unilateral Vestibular Neuritis

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