Methods for Testing the Subjective Visual Vertical during the Chronic Phase of Menière’s Disease

Abstract

The subjective visual vertical (SVV) evaluates the function of the utricle, which, in patients with Menière’s disease (MD), can be affected by endolymphatic hydrops. This study aimed to determine the SVV in MD patients during the chronic phase of illness compared to healthy participants. The second aim was to compare the SVV measurement tools: the analog bucket test, digital bucket test, and C-SVV© goggles. The SVV scores differed significantly between MD patients and the control group for the analog bucket test (p < 0.001) and the C-SVV® goggles (p = 0.028), but no significance was shown when using the digital bucket test (p = 0.062). When comparing the analog bucket test and the C-SVV® goggles applying the calculated threshold (1.125° in analog bucket test, 2.5° in C-SVV® goggles), the bucket test showed higher accuracy (bucket test 73.84%, C-SVV® goggles 69.23%). When examining the influence of betahistine on SVV scores, there were no statistically significant differences in both the analog bucket test and C-SVV© goggles. We conclude that SVV test can be used as an additional tool to evaluate utricle function during the chronic phase of MD and that the analog bucket test produces the most reliable results. The intake of betahistine does not influence the perception of SVV.

Gravity perception disturbance in patients with unilateral Meniere disease

“…The combined total was 37.4% cases of unilateral MD. Previous studies using the conventional HU‐SVV test have reported a GPD diagnosis rate of 63.3% in acute MD, 28 46.2% in chronic MD, 29 and 25%–50% in chronic vertigo including MD. 30 As most of the patients in this study had chronic unilateral MD, our results are reasonable.…”

Subjective Visual Vertical and Vestibular Evoked Myogenic Potential in Meniere's disease

“…The SVV assessed through the bucket method was identified in only five studies in MD. 37 , 38 , 39 , 40 , 41…”

Perspectives: Evaluation of Older Adult Cochlear Implant Candidates for Fall Risk in a Developing Country Setting

“…Instrumented versions of tests such as Dynamic Visual Acuity are available for download to computers and in a virtual reality format. Mobile apps of the Subjective Visual Vertical test have been released at very little cost and are being evaluated for sensitivity and specificity (61)(62)(63)(64). Commercially available interactive exergaming technology, such as the Wii Fit, is shown to give valuable and accurate information regarding balance control (65) and can be used for pre-habilitation and rehabilitation post-implantation.…”

“…The Subjective Visual Vertical (SVV) test can be done in an analog form or digitally using a mobile phone app, both in a bucket ( 64 ). Vestibular lesions are known to influence the perception of gravitational vertical.…”

“…Results are resistant to changes with age, making SVV appealing for an older adult population. Of interest for older CI candidates, some researchers suggest that the SVV can be helpful in the chronic phase of Ménière's disease ( 64 ) although, as with all the screening tests in this section, there have been questions regarding SVV's sensitivity and specificity ( 73 ). A recent meta-analysis has gone some way to refine the role of SVV in patients with peripheral vestibular disorder, and pooled results recommend SVV for the evaluation of vestibular function in patients undergoing vestibular surgery, such as vestibular schwannoma removal ( 74 ).…”