Comparative utility of vestibular function tests in patients with peripheral and central vestibular dysfunctionOA
Background: Bithermal caloric irrigation, video head impulse test(vHIT), and rotational testing are commonly used to assess peripheral vestibular function, but the relative clinical utility of each test in differentiating patients with peripheral vestibulopathy is debated.Objectives: To determine whether(1) the combination of two or more vestibular tests enhances diagnostic utility over a single test;(2) abnormal test results on vestibular tests correlate with one another.Methods: Retrospective analysis of data collected from multidisciplinary vestibular clinics at two academic medical centers from 2016 to 2022.Results: 150 patients(54.10 ± 15.09 years, 88 females) were included. No individual test was significantly better at predicting the presence of peripheral vestibular damage(p > 0.05). vHIT test results improved significantly when combined with either the caloric test(p = 0.007) or rotary chair test(p = 0.039). Caloric and rotational testing had high sensitivity(74.65% and 76.06%, respectively) and specificity(83.54% and 78.48%, respectively). vHIT demonstrated excellent specificity(89.87%) but poor sensitivity(47.89%). Caloric, vHIT, and rotary chair tests results did not correlate with one another(p > 0.05).Conclusions: Vestibular function tests have comparable diagnostic utility, yet each offers unique advantages. Caloric and rotational testing may be best suited for screening peripheral damage and vHIT may function ideally as a confirmatory test.
Cameron B.Fattahi;Christopher Zaro;Janice J.Chung;Richard F.Lewis;Divya A.Chari;
Department of Otolaryngology-Head and Neck Surgery,UMASS Memorial Medical Center,University of Massachusetts Chan Medical School,Worcester,MA,USA Jenks Vestibular Physiology Laboratory,Massachusetts Eye and Ear,Boston,MA,USADepartment of Otolaryngology-Head and Neck Surgery,UMASS Memorial Medical Center,University of Massachusetts Chan Medical School,Worcester,MA,USADepartment of Otolaryngology-Head and Neck Surgery,Massachusetts Eye and Ear,Harvard Medical School,Boston,MA,USAJenks Vestibular Physiology Laboratory,Massachusetts Eye and Ear,Boston,MA,USA Department of Otolaryngology-Head and Neck Surgery,Massachusetts Eye and Ear,Harvard Medical School,Boston,MA,USA Department of Neurology,Harvard Medical School,Boston,MA,USADepartment of Otolaryngology-Head and Neck Surgery,UMASS Memorial Medical Center,University of Massachusetts Chan Medical School,Worcester,MA,USA Jenks Vestibular Physiology Laboratory,Massachusetts Eye and Ear,Boston,MA,USA Department of Otolaryngology-Head and Neck Surgery,Massachusetts Eye and Ear,Harvard Medical School,Boston,MA,USA
临床医学
vestibularpatientsspecificity
《Journal of Otology》 2024 (001)
P.5-9 / 5
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