So Raymond J, Cevallos Ashley, Pile Macie, Biju Kevin, Perez-Heydrich Carlos, Padova Dominic, Walker Courtney, Schubert Michael, Agrawal Yuri
Department of Otolaryngology Johns Hopkins University School of Medicine Baltimore Maryland USA.
Medical Student Training in Aging Research Program, Department of Geriatric Medicine and Gerontology Johns Hopkins University School of Medicine Baltimore Maryland USA.
Laryngoscope Investig Otolaryngol. 2023 Apr 28;8(3):758-762. doi: 10.1002/lio2.1069. eCollection 2023 Jun.
To develop a novel remote head impulse test (rHIT), and to provide preliminary data validating the rHIT vestibular-ocular reflex (VOR) gains against the in-clinic vHIT.
A convenience sample of 10 patients referred for vestibular assessment at our institution was recruited. In-clinic vHIT was used to quantify lateral VOR gains. Patients subsequently underwent an rHIT protocol, whereby patients performed active, lateral head rotations while their eyes and heads were recorded using a laptop camera and video-conferencing software. The vHIT and rHIT VOR gains were compared using paired -tests, and a Pearson correlation coefficient between the gains was calculated. Absolute accuracy, sensitivity, and specificity of the rHIT were additionally calculated.
Of the 10 patients recruited, 4 were male, and the average ± standard deviation (SD) age was 61.4 ± 15.3 years. As determined by the vHIT, 2 patients had normal bilateral VOR gains, 6 with unilateral vestibular hypofunction, and 2 with bilateral vestibular hypofunction. The correlation between the rHIT and vHIT gains was 0.73 ( < .001). The rHIT exhibited an absolute accuracy of 75.0%, sensitivity of 70.0%, and specificity of 80.0%. When ears had a vHIT VOR gain less than 0.40, the rHIT exhibited 100.0% accuracy. Conversely, 60.0% of deficient ears with vHIT VOR gains greater than 0.40 were incorrectly categorized by the rHIT.
The rHIT may be better suited for detecting more severe vestibular deficiencies. Future iterations of the rHIT should aim to increase the video frame-rate capabilities to detect subtler VOR impairments.
开发一种新型远程摇头试验（rHIT），并提供初步数据以验证rHIT的前庭眼反射（VOR）增益与临床内vHIT的对比情况。
选取在我们机构接受前庭评估的10例患者作为便利样本。使用临床内vHIT来量化外侧VOR增益。患者随后接受rHIT方案，即患者进行主动的外侧头部旋转，同时使用笔记本电脑摄像头和视频会议软件记录其眼睛和头部情况。使用配对t检验比较vHIT和rHIT的VOR增益，并计算增益之间的Pearson相关系数。此外还计算了rHIT的绝对准确性、敏感性和特异性。
在招募的10例患者中，4例为男性，平均年龄±标准差（SD）为61.4±15.3岁。根据vHIT确定，2例患者双侧VOR增益正常，6例单侧前庭功能减退，2例双侧前庭功能减退。rHIT和vHIT增益之间的相关性为0.73（P<0.001）。rHIT的绝对准确性为75.0%，敏感性为70.0%，特异性为80.0%。当耳朵的vHIT VOR增益小于0.40时，rHIT的准确性为100.0%。相反，vHIT VOR增益大于0.40的缺陷耳朵中有60.0%被rHIT错误分类。
rHIT可能更适合检测更严重的前庭缺陷。rHIT的未来迭代应旨在提高视频帧率能力，以检测更细微的VOR损伤。
4级。
