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Molnár A, Maihoub S, Tamás L, Szirmai Á. Comparison between caloric and video-head impulse tests in Ménière's disease and vestibular neuritis. Int J Audiol 2022; 62:393-399. [PMID: 35439091 DOI: 10.1080/14992027.2022.2059711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To compare the diagnostic accuracies of air caloric testing with electronystagmography and the vHIT (video-head impulse test). DESIGN Prospective, controlled study. STUDY SAMPLE MD (Ménière's disease), 26; vestibular neuritis, 27; control, 56. RESULTS In MD, CP (canal paresis) was pathological in 88.5%, the GA (gain asymmetry) on vHIT was pathological in 65.3%, and the gain was abnormal in only one patient. The GA and CP, were significantly higher in the MD group than in the control group, indicating hypofunction of the horizontal canals in MD, whereas a hyperfunction may also occur. No correlation was observed between the results of the two tests for evaluating MD, suggesting that pathological outcomes of one test do not guarantee abnormalities on the other test. For vestibular neuritis, significantly higher CP (96.3%), GA (81.5%), and gain (51.9%) values were detected. A correlation was identified between the two tests for vestibular neuritis, indicating a similar diagnostic efficiency. The higher percentage of pathological GA versus pathological gain values indicates that the asymmetry may be more informative. CONCLUSIONS The vHIT showed a higher specificity, whereas the caloric test a higher sensitivity. No correlation between the two methods was observed; therefore, the tests appear to provide complementary information.
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Affiliation(s)
- András Molnár
- Faculty of Medicine, Department of Otolaryngology and Head and Neck Surgery, Semmelweis University, Budapest, Hungary
| | - Stefani Maihoub
- Faculty of Medicine, Department of Otolaryngology and Head and Neck Surgery, Semmelweis University, Budapest, Hungary
| | - László Tamás
- Faculty of Medicine, Department of Otolaryngology and Head and Neck Surgery, Semmelweis University, Budapest, Hungary
| | - Ágnes Szirmai
- Faculty of Medicine, Department of Otolaryngology and Head and Neck Surgery, Semmelweis University, Budapest, Hungary
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Wu CN, Luo SD, Chen SF, Huang CW, Chiang PL, Hwang CF, Yang CH, Ho CH, Cheng WD, Lin CY, Li YL. Applicability of Oculomotor Tests for Predicting Central Vestibular Disorder Using Principal Component Analysis. J Pers Med 2022; 12:jpm12020203. [PMID: 35207691 PMCID: PMC8880333 DOI: 10.3390/jpm12020203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/12/2022] [Accepted: 01/27/2022] [Indexed: 11/23/2022] Open
Abstract
The videonystagmography oculomotor test battery is considered useful method for diagnosing vertigo. However, its role in diagnosing central vestibular disorder has not been clarified due to variations in interpretation. Patients (n = 103) with vertigo or dizziness symptoms undergoing the oculomotor tests and brain MRI within 1 month were analyzed. Two otology specialists retrospectively interpreted the oculomotor tests, and three neurology and neuroradiology specialists determined whether central lesions were present on brain MRI. Multivariable logistic regression analysis was performed to determine the factors contributing to discordant interpretation between oculomotor tests and brain MRI. Oculomotor tests predicting central lesions were assessed using principal component analysis. The intra- and inter-rater reliability in oculomotor test interpretation was moderate to good. Age > 60 years and multiple comorbidities were significant predictors of a discordant interpretation between MRI and oculomotor tests. Positive neurological symptoms and a higher oculomotor index (according to saccade (vertical axis), smooth pursuit (horizontal axis), and gaze-evoked nystagmus (horizontal/vertical axes) tests) significantly predicted central vestibular disorder in vertigo patients. Caution is required when interpreting the results of the oculomotor test battery for diagnosis of central lesions in older patients, as well as in those with multiple comorbidities.
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Affiliation(s)
- Ching-Nung Wu
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-N.W.); (S.-D.L.); (C.-F.H.); (C.-H.Y.); (C.-H.H.); (W.-D.C.)
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
| | - Sheng-Dean Luo
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-N.W.); (S.-D.L.); (C.-F.H.); (C.-H.Y.); (C.-H.H.); (W.-D.C.)
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Shu-Fang Chen
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (S.-F.C.); (C.-W.H.)
| | - Chi-Wei Huang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (S.-F.C.); (C.-W.H.)
| | - Pi-Ling Chiang
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Chung-Feng Hwang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-N.W.); (S.-D.L.); (C.-F.H.); (C.-H.Y.); (C.-H.H.); (W.-D.C.)
| | - Chao-Hui Yang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-N.W.); (S.-D.L.); (C.-F.H.); (C.-H.Y.); (C.-H.H.); (W.-D.C.)
| | - Chun-Hsien Ho
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-N.W.); (S.-D.L.); (C.-F.H.); (C.-H.Y.); (C.-H.H.); (W.-D.C.)
| | - Wei-De Cheng
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-N.W.); (S.-D.L.); (C.-F.H.); (C.-H.Y.); (C.-H.H.); (W.-D.C.)
| | - Chung-Ying Lin
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
- Department of Occupational Health, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
- Correspondence: (C.-Y.L.); (Y.-L.L.); Tel.: +886-6-235-3535 (ext. 5311) (Y.-L.L.)
| | - Yi-Lu Li
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Correspondence: (C.-Y.L.); (Y.-L.L.); Tel.: +886-6-235-3535 (ext. 5311) (Y.-L.L.)
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