András Molnár1, Stefani Maihoub MD1, László Tamás MD, PhD1, Ágnes Szirmai MD, PhD1
1 Semmelweis University, Department of Otolaryngology and Head and Neck Surgery, Budapest
Introduction: Caloric vestibular (CVT) and video-head impulse (vHIT) tests are methods used for the evaluation of vestibular function, allow to record and measure the vestibulo-ocular reflex.
Aims: The aim of our study is to compare the diagnostic accuracy of the two tests in vestibular disorders.
Method: A total of 204 patients (64 male, 140 females, mean age: 55.6 years ± 14.07 SD) were enrolled in this investigation. During complete otoneurological examination subjects suffering from BPPV (benign paroxysmal positional vertigo) (57), Ménière’s disease (21), vestibular neuronitis (20), other vestibulopathy (29), central vestibular lesion (33) and 44 patients with normal vestibular system as control were examined. VHIT was performed using ICS Impulse System (Otometrics 1085) and caloric test applying CHARTR air caloric stimulator NCA-200. Statistical analysis was performed using IBM SPSS V24 software. Both tests record the function of the horizontal semicircular canals, CP% (canal paresis) and Ga% (gain asymmetry) values were contrasted based on kappa coefficient and Spearman’s rank correlation. Moreover, ROC (receiver operating characteristic) analysis was also applied.
Results: There is no statistical correlation between CP% and Ga% parameters of normal patients and of those involved in disorder. Correlation was only detected between CP% of normal and BPPV patients (kappa=0.359), so canal paresis is not typical, but Ga% was pathologic in 63% (kappa=0.091). Slight agreement came up in neuronitis, indicating same diagnostic value of the two methods. In the other disorders CP% was pathologic in most of the cases. It is noteworthy that gain value is not enough by itself (pathologic only in 10%), asymmetry is more sensitive (pathologic in 54%). According to ROC analysis Ga% is more specific, while CP% is more sensitive.
Conclusion: Combined application of the two methods is necessary. Beside the gain value Ga% has to be taken into consideration too.
Doctoral School: Clinical Medicine
Program: Otoneurology, Vestibular disorders
Supervisor: Dr. Ágnes Szirmai PhD
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