Khater Ahmed Mohammed, Afifi Pretty O
Zagazig Faculty of Medicine, Egypt.
Ain Shams Faculty of Medicine, Egypt.
Int J Pediatr Otorhinolaryngol. 2016 Aug;87:172-7. doi: 10.1016/j.ijporl.2016.06.030. Epub 2016 Jun 11.
The caloric test and the video head-impulse test are diagnostic tools to examine dizzy patients through assessing the function of the semicircular canals. There are major differences between the two tests as regards stimulus characteristics, methodology, and function examined. The aim of this study is to evaluate the results of vHIT in children and adolescents with normal caloric test.
This work was performed on 63 patients, but 14 were excluded because of technical problems in the caloric test. So, this is a prospective work in 49 patients (27 females and 22 males) with different types of vestibular disease seen because of vertigo in which both procedures were performed the same day. The caloric test was performed with air at two different temperatures in which both ears were irrigated alternately. Then, the video head-impulse test was carried out. Main outcome measures were the gain of vestibulo-ocular reflex, gain asymmetry, and refixation saccades in the vHIT.
in all studied cases, caloric test was normal. The mean age of patients was 16 years. By vHIT, in 8 patients (16%) no abnormality was detected, while abnormal findings were found in 41 patients. Single canal affection was seen in 29 patients whereas 12 patients had combined canal affection. The right side was affected in 27 and left side in 22 patients. In single canal affection, isolated horizontal canals were affected in 4, anterior canals in 5 and posterior canals in 20 patients. While in combined canal affection, the affection is seen in the same ear. Moreover the most common pattern seen is affection of left anterior and left posterior canals.
The caloric and vHIT is very important tests in diagnosis of dizzy patients. The information from both methods is redundant in some cases but complementary in most. vHIT is a "child friendly," relatively easy-to-use, and simple tool to evaluate each of the 6 semicircular canals.
冷热试验和视频头脉冲试验是通过评估半规管功能来检查眩晕患者的诊断工具。这两种测试在刺激特征、方法和所检查的功能方面存在重大差异。本研究的目的是评估冷热试验正常的儿童和青少年的视频头脉冲试验结果。
本研究对63例患者进行，但由于冷热试验存在技术问题，排除了14例。因此，这是一项针对49例患者（27例女性和22例男性）的前瞻性研究，这些患者因眩晕而患有不同类型的前庭疾病，且两种检查均在同一天进行。冷热试验采用两种不同温度的空气交替冲洗双耳。然后，进行视频头脉冲试验。主要观察指标为视频头脉冲试验中的前庭眼反射增益、增益不对称性和重新注视扫视。
在所有研究病例中，冷热试验均正常。患者的平均年龄为16岁。通过视频头脉冲试验，8例患者（16%）未检测到异常，而41例患者发现异常。29例患者为单半规管受累，12例患者为联合半规管受累。右侧受累27例，左侧受累22例。在单半规管受累中，孤立的水平半规管受累4例，前半规管受累5例，后半规管受累20例。而在联合半规管受累中，受累发生在同一耳。此外，最常见的模式是左侧前半规管和左侧后半规管受累。
冷热试验和视频头脉冲试验在眩晕患者的诊断中非常重要。两种方法提供的信息在某些情况下是冗余的，但在大多数情况下是互补的。视频头脉冲试验是一种“儿童友好”、相对易于使用且简单的工具，可用于评估6个半规管中的每一个。
