Melville I Zay, Yamsuan Kyla, Wu Helen, Thorne Peter R, Kobayashi Kei, Taylor Rachael L
Section of Audiology, School of Population Health, University of Auckland, Auckland, New Zealand.
Eisdell Moore Centre for Hearing and Balance Research, University of Auckland, New Zealand.
Clin Neurophysiol Pract. 2024 Jul 9;9:217-226. doi: 10.1016/j.cnp.2024.07.001. eCollection 2024.
To investigate the relative sensitivity and agreement of caloric testing and video head impulse test (vHIT) across four groups of vestibular disorders.
Caloric and vHIT results of 118 patients with either Ménière's disease, vestibular neuritis/labyrinthitis, vestibular migraine, or vestibular schwannoma were retrospectively analyzed. vHIT gain, gain asymmetry, and catch-up-saccades (≥100°/sec) were compared with reference limits of 91 controls.
Abnormal caloric results and vHIT gain were recorded in 57.6 % and 33.1 % of patients, respectively. Consideration of all three measures increased vHIT sensitivity to 43.2 %, and concordance with caloric results improved from 66.1 % to 70.3 %. A significant interaction effect confirmed the relationship between tests depended on the diagnosis (p = 0.013). Vestibular migraine and vestibular neuritis/labyrinthitis produced similar results on both tests, usually normal and abnormal respectively. Vestibular schwannoma produced more caloric abnormalities than vHIT gain but not compared with catch-up-saccades and gain asymmetry; Ménière's disease produced more caloric abnormalities than all vHIT measures. When vHIT was normal (all measures), a 37 % canal paresis was 90 % specific for Ménière's disease.
Rates of vHIT catch-up-saccades and gain asymmetry can improve sensitivity and concordance with caloric testing, but this is disease-dependent.
vHIT outcome measures are complementary to the caloric test and each other.
研究热量试验与视频头脉冲试验（vHIT）在四组前庭疾病中的相对敏感性和一致性。
回顾性分析118例梅尼埃病、前庭神经炎/迷路炎、前庭性偏头痛或前庭神经鞘瘤患者的热量试验和vHIT结果。将vHIT增益、增益不对称性和追视扫视（≥100°/秒）与91名对照者的参考限值进行比较。
分别有57.6%和33.1%的患者热量试验结果和vHIT增益异常。综合考虑所有三项指标可将vHIT的敏感性提高到43.2%，与热量试验结果的一致性从66.1%提高到70.3%。显著的交互作用证实了两种测试之间的关系取决于诊断（p = 0.013）。前庭性偏头痛和前庭神经炎/迷路炎在两种测试中产生的结果相似，通常分别为正常和异常。前庭神经鞘瘤产生的热量异常比vHIT增益多，但与追视扫视和增益不对称性相比无差异；梅尼埃病产生的热量异常比所有vHIT指标都多。当vHIT正常（所有指标）时，37%的半规管轻瘫对梅尼埃病的特异性为90%。
vHIT追视扫视和增益不对称率可提高与热量试验的敏感性和一致性，但这取决于疾病类型。
vHIT结果指标与热量试验相互补充。
