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ORIGINAL RESEARCH
What Can We Predict with Video Head Impulse Test in Unilateral Vestibular Disorders?
Tek Taraflı Vestibüler Hastalıklarda Video Head Impulse Test ile Neleri Öngörebiliriz?
Received Date : 29 Jul 2020
Accepted Date : 25 Sep 2020
Available Online : 23 Dec 2020
Özet PDF Benzer Makaleler
Sabuhi JAFAROVa, Hüseyin Samet KOCAa, Evren HIZALa, Levent Naci ÖZLÜOĞLUa
aDepartment of Otorhinolaryngology, Başkent University Faculty of Medicine, Ankara, TURKEY
Doi: 10.24179/kbbbbc.2020-78320 - Makale Dili: EN
KBB ve BBC Dergisi. 2020;28(3):289-95
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: We applied video head impulse test (vHIT) to all patients before audio-vestibular test battery and aimed to investigate the vestibular problems which can be predicted by vHIT in various vestibular disorders. Material and Methods: The data of 88 patients diagnosed with various unilateral vestibular disorders were examined in this prospective study. Ear-nose-throat (ENT) examination, vHIT, pure tone audiometry, cervical vestibular evoked myogenic potential and videonystagmography including caloric test were applied to all patients respectively. Results: Abnormal vHIT (horizontal and/or vertical canals) was determined in 81.8% of the patients with unilateral vestibular disorder. Abnormal horizontal canal vHIT was seen in 74.5% of the patients with canal paresis and in 46.3% of the patients without canal paresis in caloric irrigation (p<0.05). Abnormal posterior vHIT was determined in 44.7% of the patients with canal paresis and in 65.9% of the patients without canal paresis in caloric irrigation (p<0.05). Abnormal vHIT was found in all of 8 patients with BPPV included the study Comorbid disease and/or vestibular hypofunction was also found in all of 8 patients after all vestibular tests. Abnormal vHIT (horizontal and/or vertical canals) was found in the majority of patients (29/31) with Meniere’s disease. Conclusion: The results showed that unilateral vestibular hypofunction could be determined largely by vHIT. The localization of pathology may be estimated by performing both lateral and vertical vHIT. Performing vHIT before provocative maneuvers might be useful in predicting a comorbid disease and treatment success in patients with BPPV.
Keywords: Head impulse test; caloric test; vertigo; vestibular diseases
ÖZET
Amaç: Bu çalışmada, çeşitli vestibüler hastalıklarda odyovestibüler test bataryası öncesinde video head impulse test (vHIT) yaparak vHIT ile öngörülebilen vestibüler patolojileri araştırmayı amaçladık. Gereç ve Yöntemler: Bu prospektif çalışmada çeşitli tek taraflı vestibüler hastalık tanısı alan 88 hastanın verileri incelendi. Tüm hastalara sırasıyla kulak burun boğaz muayenesi ve vHIT, saf ses odyometrisi, servikal vestibüler uyarılmış miyojenik potansiyeller (cVEMP), kalorik test dahil videonistagmografi testleri yapıldı. Bulgular: Hastaların %81,8’inde anormal vHIT (horizontal ve/veya vertikal kanal teslerinde) bulguları vardı. Kalorik testte kanal parezisi bulunan hastaların %74.5’inde, kanal parezisi bulunmayan hastaların ise %46,3’ünde anormal horizontal kanal vHIT bulguları saptandı (p<0,05). Kalorik testte kanal parezisi bulunan hastaların %44,7’sinde, kanal parezisi bulunmayan hastaların ise %65,9’unda anormal posterior kanal vHIT bulguları saptandı (p<0,05). Çalışmaya dahil edilen 8 BPPV hastasının tümünde anormal vHIT bulguları görüldü. Bu 8 hastanın tümünde tüm odyovestibüler testler tamamlandıktan sonra etkilenen tarafta komorbid hastalık ve/veya vestibüler hipofonksiyon doğrulandı. Meniere hastalarının çoğunda (29/31) anormal vHIT bulguları (horizontal ve/veya vertikal kanal testlerinde) vardı. Sonuç: Bulgular, tek taraflı vestibüler hipofonksiyonun çoğu hastada vHIT ile belirlenebileceğini göstermektedir. Patolojinin lokalizasyonu hem horizontal, hem de vertikal vHIT yapılarak tahmin edilebilir. BPPV hastalarında provokotif manevra öncesinde vHIT uygulanması komorbid vestibüler hastalıkları ve tedavi başarısını öngörmede faydalı olabilir.
Anahtar Kelimeler: Head impulse test; kalorik test; vertigo; vestibüler hastalıklar
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