Fattahi Cameron B, Zaro Christopher, Chung Janice J, Lewis Richard F, Chari Divya A
Department of Otolaryngology - Head and Neck Surgery, UMASS Memorial Medical Center, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Jenks Vestibular Physiology Laboratory, Massachusetts Eye and Ear, Boston, MA, USA.
J Otol. 2024 Jan;19(1):5-9. doi: 10.1016/j.joto.2023.10.002. Epub 2023 Nov 3.
Bithermal caloric irrigation, video head impulse test (vHIT), and rotational testing are commonly used to assess peripheral vestibular function, but the relative clinical utility of each test in differentiating patients with peripheral vestibulopathy is debated.
To determine whether (1) the combination of two or more vestibular tests enhances diagnostic utility over a single test; (2) abnormal test results on vestibular tests correlate with one another.
Retrospective analysis of data collected from multidisciplinary vestibular clinics at two academic medical centers from 2016 to 2022.
150 patients (54.10 ± 15.09 years, 88 females) were included. No individual test was significantly better at predicting the presence of peripheral vestibular damage ( > 0.05). vHIT test results improved significantly when combined with either the caloric test ( = 0.007) or rotary chair test ( = 0.039). Caloric and rotational testing had high sensitivity (74.65% and 76.06%, respectively) and specificity (83.54% and 78.48%, respectively). vHIT demonstrated excellent specificity (89.87%) but poor sensitivity (47.89%). Caloric, vHIT, and rotary chair tests results did not correlate with one another ( > 0.05).
Vestibular function tests have comparable diagnostic utility, yet each offers unique advantages. Caloric and rotational testing may be best suited for screening peripheral damage and vHIT may function ideally as a confirmatory test.
冷热交替灌洗、视频头脉冲试验（vHIT）和旋转试验常用于评估外周前庭功能，但对于区分外周前庭病变患者时，每项检查的相对临床效用仍存在争议。
确定（1）两种或更多前庭检查联合使用是否比单一检查具有更高的诊断效用；（2）前庭检查的异常结果是否相互关联。
对2016年至2022年从两个学术医学中心的多学科前庭诊所收集的数据进行回顾性分析。
纳入150例患者（年龄54.10±15.09岁，女性88例）。在预测外周前庭损伤的存在方面，没有一项单独检查具有显著优势（P>0.05）。当vHIT检查结果与冷热试验（P=0.007）或转椅试验（P=0.039）联合使用时，显著改善。冷热试验和旋转试验具有较高的敏感性（分别为74.65%和76.06%）和特异性（分别为83.54%和78.48%）。vHIT显示出优异的特异性（89.87%），但敏感性较差（47.89%）。冷热试验、vHIT和转椅试验的结果彼此不相关（P>0.05）。
前庭功能检查具有可比的诊断效用，但每项检查都有独特优势。冷热试验和旋转试验可能最适合筛查外周损伤，而vHIT可能最适合作为确诊试验。
