This document describes a study comparing video head impulse testing (VHIT) to caloric testing in patients with Meniere's disease. 29 patients underwent both VHIT and caloric testing. VHIT found reduced vestibulo-ocular reflex (VOR) gain in 55% of cases, most commonly in the horizontal canals and occasionally in the vertical canals. Comparison to caloric testing found that VHIT detected abnormalities in 75.9% of cases where caloric was abnormal, and VHIT was normal in 10.3% of cases where caloric was normal. The study concludes that VHIT detects VOR deficits in Meniere's patients more often than caloric testing alone.

1. VHIT in Meniere’s disease
Dusan Pavlovic
Hearing and Balance Center Belgrade

2. Diagostics in Meniere’s
•Audiometry
•ECoG
•Caloric test
•VEMP
•MRI of ear

3. AIM
To describe VHIT in Meniere’s disease
To compare it with caloric test

4. Patients and Methods
•29 pt from Jan 14 to Jan 16, with definite MD according to AAO-HNS
•Age: 54 yr / from 30 to 74 /
•15 man 14 woman
•9 Right ears 20 Left ears
•Duration of disease: 45,5 months / from 3 to 180 /
•Bithermal caloric test:
23% paresis or directional preponderance
•VHIT in all 6 canals

5. Control group
96 healthy subjects
Reference value: Mean gain - 2STD
Horizontal canal: 0,85
Anterior canal: 0,95
Posterior canal: 0,85
Posterior canal 60+ : 0,70

6. Deficient VOR in %

7. VOR gain

8. VOR gain doesn’t depend on years of illness

9. Comparation with caloric test
VHIT normal VHIT pat.
Caloric norm 10,34% (3) 13,79% (4) 24,13% (7)
Caloric pat. 34,48% (10) 41,37% (12) 75,86% (22)
44,82% (13) 55,17% (16) 100% (29)

10. VOR gain
VHIT normal VHIT pat.
Caloric norm 1,0 0,75
Caloric pat. 0,96 0,75
0,97 0,75

11. Conclusions
•Pt with Meniere’s disease show deficit in high VOR fr. just in 55% of cases.
•VOR deficit is mostly in horizontal canals, rarely in vertical; in almost half of
cases reduced gain is on the contralateral side also
•Average reduction of VOR is 0,75
•Deficit in low VOR fr. doesn’t influence deficit in high fr
•Gain reduction isn’t influenced with caloric test result
•Gain reduction doesn’t depend on length of disease
DusanPavlovic.com/lectures/