Abstract
Objective: The use of goggles to assess vertical semicircular canal function has become a standard method in vestibular testing, both in clinic and in research, but there are different methods and apparatus in use. The aim of this study was to determine what the cause of the systematic differences is between gain values in testing of the vertical semicircular canals with two different video head impulse test (vHIT) equipment in subjects with normal vestibular function.Study Design: Retrospective analysis of gain values on patients with clinically deemed normal vestibular function (absence of a corrective eye saccade), tested with either Interacoustics or Otometrics system. Prospective testing of subjects with normal vestibular function with the camera records the eye movements of both eyes. Finally, 3D sensors were placed on different positions on the goggles measuring the actual vertical movement in the different semicircular planes.Results: In the clinical cohorts, the gain depended on which side and semicircular canal was tested (p < 0.001). In the prospective design, the combination between the stimulated side, semicircular canal, and position of the recording device (right/left eye) highly influenced the derived gain (p < 0.001). The different parts of the goggles also moved differently in a vertical direction during vertical semicircular canal testing.Conclusion: The gain values when testing the function of the vertical semicircular canals seem to depend upon which eye is recorded and which semicircular plane is tested and suggests caution when interpreting and comparing results when different systems are used both clinically as well as in research. The results also imply that further research and development are needed to obtain accurate vertical semicircular canal testing, in regard to both methodology and equipment design.
Highlights
Vestibular testing has, in the last two decades, experienced tremendous progress, and it is possible to evaluate all five sensory receptors of the inner ear
It is possible to assess the function of the vertical semicircular planes in a clinical situation as well [2], those canals are more frequently evaluated with a device measuring both eye and head velocity [3], commonly referred to as vHIT
In part 2, we examined 12 healthy volunteers (5M, 7F) aged 33 ± 10.8 years. vHIT with the Interacoustics system was performed
Summary
Vestibular testing has, in the last two decades, experienced tremendous progress, and it is possible to evaluate all five sensory receptors of the inner ear. The bedside head impulse test has become one of the most important and useful clinical tests when examining patients suffering from acute dizziness or vertigo [1]. This bedside test consists of a quick low-amplitude rotation of the patient’s head while keeping vision on a target, stimulating the semicircular canals in the plane of the head movement. It is possible to assess the function of the vertical semicircular planes in a clinical situation as well [2], those canals are more frequently evaluated with a device measuring both eye and head velocity [3], commonly referred to as vHIT (video head impulse test). The devices have been described and tested for their clinical usefulness [6, 7]
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