Blödow A, Helbig R, Wichmann N, Bloching M, Walther L E
Klinik für Hals-, Nasen-, Ohrenheilkunde, Plastische Chirurgie und Kommunikationsstörungen, Helios-Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland.
HNO. 2013 Apr;61(4):327-34. doi: 10.1007/s00106-012-2592-0.
Side-specific test procedures are mandatory in order to assess the function of peripheral vestibular receptors. Semicircular canals (SCC) and vestibulo-ocular reflex (VOR) can be tested by the Halmagyi and Curthoy head impulse test (HIT) and recently by means of the video head impulse test (vHIT). The vHIT procedure is a new method to measure eye and head velocity during brief and rapid head impulses. This method provides objective information of VOR and detects both overt and covert catch-up saccades.
As clinical experiences with vHIT are limited, in this study the horizontal VOR (hVOR) was examined by means of the vHIT in 142 consecutive patients with acute or chronic vestibular syndrome.
A total of 20 healthy volunteers served as a control group and exhibited a normal average VOR gain of 0.97 ± 0.09 without re-fixation saccades. In patients, 47.6% showed a pathological vHIT whereas 52.4% revealed a normal test result. Covert catch-up saccades could be revealed in 13.7% by means of vHIT whereas in 86.3% overt catch-up saccades alone or in combination with covert catch-up saccades were found in the majority of catch-up saccades in peripheral vestibular disorders.
By means of the vHIT it is possible to obtain a side-specific and quantitative assessment of hVOR. Video-head impulse test is a reliable tool for vestibular testing even in bedside examinations of patients suffering from dizziness.
为评估外周前庭感受器的功能，必须采用特定侧别的测试程序。半规管（SCC）和前庭眼反射（VOR）可通过哈尔马吉和库尔索伊头脉冲试验（HIT）进行检测，最近也可通过视频头脉冲试验（vHIT）进行检测。vHIT程序是一种在短暂快速头脉冲期间测量眼和头速度的新方法。该方法可提供VOR的客观信息，并检测显性和隐性追赶性扫视。
由于vHIT的临床经验有限，本研究采用vHIT对142例连续的急性或慢性前庭综合征患者的水平VOR（hVOR）进行了检查。
共有20名健康志愿者作为对照组，其平均VOR增益正常，为0.97±0.09，无再固定性扫视。在患者中，47.6%的患者vHIT结果异常，而52.4%的患者测试结果正常。通过vHIT可在13.7%的患者中检测到隐性追赶性扫视，而在86.3%的外周前庭疾病患者中，大多数追赶性扫视中可发现单独的显性追赶性扫视或显性与隐性追赶性扫视并存。
通过vHIT可以获得hVOR的特定侧别和定量评估。即使在对头晕患者进行床边检查时，视频头脉冲试验也是一种可靠的前庭测试工具。
