Comment on “Monothermal Caloric Testing in the Screening of Vestibular Function”

2011 ◽  
Vol 82 (4) ◽  
pp. 485-486
Author(s):  
Xie Su Jiang ◽  
Wang Jiang Chang ◽  
Sun Xi Qing
Keyword(s):  
Vestibular Function ◽  
Caloric Testing

scholarly journals Vestibular Preservation After Cochlear Implantation Using the Round Window Approach

2021 ◽  
Vol 12 ◽  
Author(s):  
Keita Tsukada ◽  
Shin-ichi Usami
Keyword(s):  
Cochlear Implantation ◽  
Round Window ◽  
Surgical Techniques ◽  
Vestibular Function ◽  
Vestibular Evoked Myogenic Potential ◽  
Flexible Electrodes ◽  
Caloric Testing ◽  
Before And After ◽  
Window Approach ◽  
Caloric Response

Background: The development of less traumatic surgical techniques, such as the round window approach (RWA), as well as the use of flexible electrodes and post-operative steroid administration have enabled the preservation of residual hearing after cochlear implantation (CI) surgery. However, consideration must still be given to the complications that can accompany CI. One such potential complication is the impairment of vestibular function with resulting vertigo symptoms. The aim of our current study was to examine the changes in vestibular function after implantation in patients who received CI using less traumatic surgery, particularly the RWA technique.Methods: Sixty-six patients who received CI in our center were examined by caloric testing, cervical vestibular evoked myogenic potential (cVEMP) and ocular VEMP (oVEMP) before or after implantation, or both, to obtain data on semicircular canal, saccular and utricular function, respectively. Less traumatic CI surgery was performed by the use of the RWA and insertion of flexible electrodes such as MED-EL FLEX soft, FLEX 28, and FLEX 24 (Innsbruck, Austria).Results: Caloric response and the asymmetry ratio of cVEMP and oVEMP were examined before and after implantation using less traumatic surgical techniques. Compared with before implantation, 93.9, 82.4, and 92.5% of the patients showed preserved vestibular function after implantation based on caloric testing, cVEMP and oVEMP results, respectively. We also examined the results for vestibular function by a comparison of the 66 patients using the RWA and flexible electrodes, and 17 patients who underwent cochleostomy and insertion of conventional or hard electrodes. We measured responses using caloric testing, cVEMP and oVEMP in patients after CI. There were no differences in the frequencies of abnormal caloric and oVEMP results in the implanted ears between the RWA and cochleostomy. On the other hand, the frequency of abnormal cVEMP responses in the implanted ears in the patients who received implantation by cochleostomy was significantly higher than that in the patients undergoing surgery using the RWA.Conclusion: Patients receiving CI using less traumatic surgical techniques such as RWA and flexible electrodes have reduced risk of damage to vestibular function.

scholarly journals Saccades Matter: Reduced Need for Caloric Testing of Cochlear Implant Candidates by Joint Analysis of v-HIT Gain and Corrective Saccades

2021 ◽  
Vol 12 ◽  
Author(s):  
Constanza Fuentealba Bassaletti ◽  
Babette F. van Esch ◽  
Jeroen J. Briaire ◽  
Peter Paul G. van Benthem ◽  
Erik F. Hensen ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Medical Center ◽  
Area Under The Curve ◽  
Vestibular Function ◽  
Joint Analysis ◽  
Head Impulse Test ◽  
Caloric Test ◽  
Operating Characteristics ◽  
Caloric Testing ◽  
Corrective Saccades

Objectives: Video head impulse test (v-HIT) is a quick, non-invasive and relatively cheap test to evaluate vestibular function compared to the caloric test. The latter is, however, needed to decide on the optimal side to perform cochlear implantation to avoid the risk on inducing a bilateral vestibular areflexia. This study evaluates the effectiveness of using the v-HIT to select cochlear implant (CI) candidates who require subsequent caloric testing before implantation, in that way reducing costs and patient burden at the same time.Study Design: Retrospective study using clinical data from 83 adult CI-candidates, between 2015 and 2020 at the Leiden University Medical Center.Materials and Methods: We used the v-HIT mean gain, MinGain_LR, the gain asymmetry (GA) and a newly defined parameter, MGS (Minimal Gain & Saccades) as different models to detect the group of patients that would need the caloric test to decide on the ear of implantation. The continuous model MGS was defined as the MinGain_LR, except for the cases with normal gain (both sides ≥0.8) where no corrective saccades were present. In the latter case MGS was defined to be 1.0 (the ideal gain value).Results: The receiver operating characteristics curve showed a very good diagnostic accuracy with and area under the curve (AUC) of 0.81 for the model MGS. The v-HIT mean gain, the minimal gain and GA had a lower diagnostic capacity with an AUC of 0.70, 0.72, and 0.73, respectively. Using MGS, caloric testing could be avoided in 38 cases (a reduction of 46%), with a test sensitivity of 0.9 (i.e., missing 3 of 28 cases).Conclusions: The newly developed model MGS balances the sensitivity and specificity of the v-HIT better than the more commonly evaluated parameters such as mean gain, MinGain_LR and GA. Therefore, taking the presence of corrective saccades into account in the evaluation of the v-HIT gain can considerably reduce the proportion of CI-candidates requiring additional caloric testing.

The Clinical Significance of the Failure to Perceive Vertigo in the Postcaloric Period Despite a Robust Caloric Response

2020 ◽  
Vol 29 (1) ◽  
pp. 50-58
Author(s):  
Erin G. Piker ◽  
Gary P. Jacobson ◽  
Daniel Romero ◽  
Ye Wang ◽  
Kaylee Smith
Keyword(s):  
Working Memory ◽  
Motion Perception ◽  
Postural Stability ◽  
Vestibular Function ◽  
Slow Phase ◽  
Visuospatial Memory ◽  
Visuospatial Working Memory ◽  
Dynamic Posturography ◽  
Caloric Testing ◽  
Caloric Response

Purpose The purpose of this project was to explore the association between the perception of motion during caloric testing and two tasks associated with central vestibular processing: postural stability and visuospatial memory. Method This was a prospective study of 25 patients who were found to have nonvestibular etiologies of their symptoms and normal vestibular function test results and who underwent caloric testing with a mean maximum slow phase eye velocity for each irrigation of 15° or greater. Following each caloric irrigation, patients were asked whether they had any sensation of movement. Patients were grouped based on the presence or absence of motion during the caloric exam (motion perception vs. absent perception). Postural stability was assessed using computerized dynamic posturography, and visuospatial memory was assessed using a memory match card game application. Results There were no significant differences between groups on any measures of peripheral vestibular function. However, the Absent Perception Group showed greater postural instability during Condition 5 of posturography and performed significantly worse on a task of visuospatial working memory. Both age and absence of motion perception predicted abnormal performance on measures of postural stability and visuospatial working memory. Conclusions There appears to be clinical implications to a lack of motion perception during the caloric exam in patients with an otherwise normal peripheral vestibular system. Based on the current findings, we are unable to determine whether differences in postural stability and visuospatial memory were due to age or a central vestibular processing deficit.

scholarly journals Estimation of Vestibular Function from the Analysis of Manually Rotated Vestibulo-ocular Reflex-Comparison with Caloric Testing-

2004 ◽  
Vol 63 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Yosaku Shiomi ◽  
Etsuo Yamamoto ◽  
Yoshiko Shiomi ◽  
Naoharu Oda ◽  
Mitsuko Fujihara ◽  
...  
Keyword(s):  
Vestibular Function ◽  
Caloric Testing ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex

scholarly journals comparison between video-head-impulse test and caloric testing of vestibular function

2018 ◽  
Author(s):  
A Lundershausen ◽  
P Schendzielorz ◽  
M Bürklein ◽  
K Rak ◽  
R Hagen
Keyword(s):  
Vestibular Function ◽  
Head Impulse Test ◽  
Video Head Impulse Test ◽  
Head Impulse ◽  
Caloric Testing

Monothermal Caloric Testing in the Screening of Vestibular Function

2010 ◽  
Vol 81 (4) ◽  
pp. 369-374 ◽  
Author(s):  
Avi Shupak ◽  
Margalit Kaminer ◽  
Peter Gilbey ◽  
Dror Tal
Keyword(s):  
Vestibular Function ◽  
Caloric Testing

Associations of Video Head Impulse Test and Caloric Testing among Patients with Vestibular Schwannoma

2019 ◽  
Vol 161 (2) ◽  
pp. 324-329 ◽  
Author(s):  
C. Scott Brown ◽  
Sarah B. Peskoe ◽  
Thomas Risoli ◽  
Douglas B. Garrison ◽  
David M. Kaylie
Keyword(s):  
Vestibular Schwannoma ◽  
Tumor Size ◽  
Vestibular Function ◽  
Significant Negative Correlation ◽  
Head Impulse Test ◽  
Dizziness Handicap Inventory ◽  
Tertiary Referral Hospital ◽  
Head Impulse ◽  
Caloric Testing ◽  
Unilateral Weakness

Objective To determine relationships between caloric testing (CT) and video head impulse testing (vHIT) among patients with unilateral vestibular schwannoma (VS). To describe the distribution of CT and vHIT measurements and assess associations with tumor size and self-perceived handicapping effects. Study Design Retrospective review. Setting Tertiary referral hospital. Subjects and Methods Subjects were adults with presumed unilateral VS between 2014 and 2017. Interventions were CT and vHIT. Primary outcomes were vHIT value (abnormal <0.8) and CT value (abnormal >25%). Secondary outcomes were tumor size and Dizziness Handicap Inventory scores. Results Fifty-one individuals had complete data for CT and vHIT. The odds of abnormal gain increases by 2.18 for every 10% increase in unilateral weakness on CT (range, 1.44-3.34; P < .001). A significant negative correlation between CT and gain exists ( rs = −0.64, P < .001). Odds of observing saccades increased by 2.68 for every 10% increase in unilateral weakness (range, 1.48-4.85; P = .001). This association was larger in magnitude for overt than covert saccades (odds ratios, 2.48 and 1.59, respectively). Tumor size was significantly associated with an increase in caloric weakness (β = 0.135, P < .001). With every 10-mm increase of tumor size, odds of abnormal gain on vHIT increased 4.13 (range, 1.46-11.66; P = .007). Mean Dizziness Handicap Inventory score was 19.7 (σ = 22), without association to caloric weakness, gain, or tumor size. Conclusion CT and vHIT both effectively assess vestibular function for patients with VS and correlate to tumor size. These findings are important as vHIT has a lower overall cost, improved patient tolerance, and demonstrated reliability.

Influence of Tasking During Vestibular Testing

2021 ◽  
pp. 1-6
Author(s):  
Kathryn Makowiec ◽  
Kaylee Smith ◽  
Ashley Deeb ◽  
Erica Bennett ◽  
Jenni Sis
Keyword(s):  
Statistical Significance ◽  
Vestibular Function ◽  
Slow Phase ◽  
Vestibular Disorder ◽  
Caloric Testing ◽  
Significant Difference ◽  
Verbal Tasks ◽  
History Of ◽  
Age Range ◽  
Sinusoidal Harmonic Acceleration

Purpose The purpose of this study was to investigate the effectiveness of different types of tasking on the measurement of peak slow phase velocity (SPV) for caloric testing and rotary chair testing. Method This study evaluated the peak SPV response for caloric testing and rotary chair across five conditions. Three verbal, one tactile, and one condition without tasking were used for both caloric testing and rotary chair. The subjects consisted of 20 young adults (age range: 22–33 years, M = 26.65, SD = 3.72; seven male, 13 female) with normal vestibular function and no history of ear surgery or vestibular disorder. Study participation consisted of two visits with 24 hr minimum between each, one for caloric testing and one for rotary chair testing. The test completed at each visit was counterbalanced. Caloric Testing : The caloric irrigations were performed 5 times, with the ears randomized and tasking conditions randomized. Rotary Chair Testing : Rotary chair sinusoidal harmonic acceleration testing was performed 5 times at 0.08 Hz with the tasking conditions randomized. Results Tasking of any kind resulted in significantly larger peak SPV responses when compared to the no tasking condition for rotary chair testing. When comparing each type of tasking, no significant differences were noted. No significant difference was noted when comparing the conditions with tasking to the no tasking condition for caloric testing. Conclusions Clinically, either mental or tactile tasking can be utilized as a method to reduce VOR suppression during rotary chair testing. As no difference was found when comparing different verbal tasks to each other, the type of tasking can be catered to the patient. If verbal tasking cannot be completed, the braiding tactile task is a valid substitution. Caloric results varied widely across subjects and did not reach statistical significance, so conclusions on the need for tasking cannot be drawn.

Improved preservation of the otolithic membranes

1987 ◽  
Vol 45 ◽  
pp. 914-915
Author(s):  
G. M. Cohen ◽  
J. S. Grasso ◽  
M. L. Domeier ◽  
P. T. Mangonon
Keyword(s):  
Toluidine Blue ◽  
Potassium Phosphate ◽  
Vestibular Function ◽  
Spatial Relations ◽  
White Leghorn ◽  
Supporting Cells ◽  
Semithin Sections ◽  
Micromechanical Models ◽  
Soluble Components

Any explanation of vestibular micromechanics must include the roles of the otolithic and cupular membranes. However, micromechanical models of vestibular function have been hampered by unresolved questions about the microarchitectures of these membranes and their connections to stereocilia and supporting cells. Otolithic membranes are notoriously difficult to preserve because of severe shrinkage and loss of soluble components. We have empirically developed fixation procedures that reduce shrinkage artifacts and more accurately depict the spatial relations between the otolithic membranes and the ciliary bundles and supporting cells.We used White Leghorn chicks, ranging in age from newly hatched to one week. The inner ears were fixed for 3-24 h in 1.5-1.75% glutaraldehyde in 150 mM KCl, buffered with potassium phosphate, pH 7.3; when postfixed, it was for 30 min in 1% OsO4 alone or mixed with 1% K4Fe(CN)6. The otolithic organs (saccule, utricle, lagenar macula) were embedded in Araldite 502. Semithin sections (1 μ) were stained with toluidine blue.

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