Video head impulse testing (VHIT) in the pediatric population

Abstract

ObjectivesVHIT is the first vestibular test to evaluate all six semicircular canals. This test has advantages over the rotary chair and caloric tests in evaluating children since it does not require fear-inducing darkness or provocation of dizziness. The goal of this study was to review our initial experience with VHIT in children and adolescents at a pediatric vestibular program. MethodsResults using the ICS Impulse VHIT device in 33 patients <20 years of age were retrospectively reviewed. Rotary chair testing was used to designate 26 subjects into groups with normal (n=20) and abnormal (n=6) lateral semicircular canal (LSC) function for comparison. ResultsAges ranged from 3 to 19 years (mean 13±4.3) with no statistically significant difference in mean lateral canal gains between age groups (3–10, 11–14, 15–19 years, respectively) by one-way ANOVA, p=0.111. LSC VHIT gain of <0.7 demonstrated sensitivity of 66.7%, specificity of 100%, positive predictive value of 100%, negative predictive value of 90.9% for detecting abnormal LSC function. Corrective saccades demonstrated 100% sensitivity and 100% specificity for detecting abnormal LSC function. VHIT gain <0.7 in an anterior (n=7) or posterior (n=9) canal was only found in subjects with a clinical history and abnormal findings on other tests indicative of a diagnosis involving the affected canal (e.g. benign paroxysmal positioning vertigo, vestibular neuritis, etc.). ConclusionVHIT is an effective test for evaluating semicircular canal function in children and offers major potential advantages over rotary chair and caloric testing.