Department of Otolaryngology, Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Otolaryngology, Head and Neck Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Vestib Res. 2024;34(2-3):103-112. doi: 10.3233/VES-230127.
The upright head roll test (UHRT) is a recently introduced diagnostic maneuver for lateral semicircular canal benign paroxysmal positional vertigo (LSC-BPPV).
This study aimed to evaluate the reliability and validity of the UHRT.
Two separate studies were conducted. Study 1 analyzed 827 results of videonystagmography (VNG) to assess UHRT reliability, and Study 2 analyzed 130 LSC-BPPV cases to evaluate UHRT validity.
The inter-test reliability between UHRT and the supine head roll test (SHRT) showed substantial agreement (Cohen's kappa = 0.753) in direction-changing positional nystagmus (DCPN) and almost perfect agreement (Cohen's kappa = 0.836) in distinguishing the direction of DCPN. The validity assessment of UHRT showed high accuracy in diagnosing LSC-BPPV (80.0%) and in differentiating the variant types (74.6%). UHRT was highly accurate in diagnosing the canalolithiasis type in LSC-BPPV patients (Cohen's kappa = 0.835); however, it showed only moderate accuracy in diagnosing the cupulolithiasis type (Cohen's kappa = 0.415). The intensity of nystagmus in UHRT was relatively weaker than that in SHRT (P < 0.05).
UHRT is a reliable test for diagnosing LSC-BPPV and distinguishing subtypes. However, UHRT has a limitation in discriminating the affected side owing to a weaker intensity of nystagmus than SHRT.
直立头滚试验（UHRT）是一种最近引入的用于诊断水平半规管良性阵发性位置性眩晕（LSC-BPPV）的诊断手段。
本研究旨在评估 UHRT 的可靠性和有效性。
进行了两项独立的研究。研究 1 分析了 827 例视频眼震图（VNG）结果，以评估 UHRT 的可靠性，研究 2 分析了 130 例 LSC-BPPV 病例，以评估 UHRT 的有效性。
UHRT 与仰卧头滚试验（SHRT）之间的测试间可靠性在位置性眼球震颤的方向变化（DCPN）中显示出实质性一致（Cohen's kappa=0.753），在区分 DCPN 的方向上几乎完全一致（Cohen's kappa=0.836）。UHRT 的有效性评估显示出在诊断 LSC-BPPV（80.0%）和区分变异类型（74.6%）方面的高准确性。UHRT 在诊断 LSC-BPPV 中的耳石症型（Cohen's kappa=0.835）非常准确，但在诊断壶腹嵴顶结石症型时准确性仅为中等（Cohen's kappa=0.415）。与 SHRT 相比，UHRT 中的眼球震颤强度相对较弱（P<0.05）。
UHRT 是诊断 LSC-BPPV 和区分亚型的可靠测试。然而，由于 UHRT 的眼球震颤强度比 SHRT 弱，因此在区分患侧方面存在局限性。
