Jung Hahn Jin, Lee Sangeun, Oh Hyeop, Wee Jee Hye, Cho Chang Gun, Park Joo Hyun
Department of Otorhinolaryngology-Head and Neck Surgery, Chungbuk National University College of Medicine, Chungbuk National University Hospital, Cheongju 28644, Republic of Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Dongguk University, Ilsan Hospital, Goyang 10326, Republic of Korea.
J Clin Med. 2025 Jun 18;14(12):4350. doi: 10.3390/jcm14124350.
To evaluate the clinical characteristics and diagnostic significance of dissociation between bithermal caloric test and video head impulse test (vHIT) in patients presenting with dizziness. : We retrospectively reviewed 644 patients who underwent bithermal caloric testing and vHIT at a university-affiliated general hospital. Patients were classified into concordant and discordant groups based on test results. The discordant group was further subdivided into those with abnormal caloric test and normal vHIT, and those with normal caloric test and abnormal vHIT. Demographic data, vestibular function test outcomes, and clinical diagnoses were analyzed. : Discordant results were observed in 36.5% of patients. Among these, 31.8% had abnormal caloric responses with normal vHIT, and 4.7% had normal caloric responses with abnormal vHIT. Most patients in both discordant subgroups were diagnosed with peripheral vestibular disorders, such as Ménière's disease and unilateral vestibulopathy. The abnormal caloric/normal vHIT pattern was more common and associated with low-frequency dysfunction. The normal caloric/abnormal vHIT pattern, though less frequent, also involved predominantly peripheral etiologies. : Dissociation between caloric and vHIT results is not uncommon and provides important diagnostic insights. Employing both tests in a complementary manner enhances the identification of frequency-specific vestibular deficits and supports more accurate diagnosis and management of vestibular disorders.
评估头晕患者双侧冷热试验与视频头脉冲试验（vHIT）结果分离的临床特征及诊断意义。：我们回顾性分析了一所大学附属医院中644例行双侧冷热试验及vHIT的患者。根据检查结果将患者分为结果一致组和结果不一致组。结果不一致组进一步细分为冷热试验异常而vHIT正常的患者，以及冷热试验正常而vHIT异常的患者。分析人口统计学数据、前庭功能检查结果及临床诊断。：36.5%的患者出现结果不一致的情况。其中，31.8%的患者冷热反应异常而vHIT正常，4.7%的患者冷热反应正常而vHIT异常。两个结果不一致亚组中的大多数患者被诊断为外周前庭疾病，如梅尼埃病和单侧前庭病。冷热试验异常/vHIT正常模式更为常见，且与低频功能障碍相关。冷热试验正常/vHIT异常模式虽较不常见，但主要也涉及外周病因。：冷热试验与vHIT结果分离并不罕见，且能提供重要的诊断线索。联合使用这两种检查可增强对特定频率前庭功能缺损的识别，并有助于更准确地诊断和管理前庭疾病。
