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To discuss the characteristics of subjective visual gravity (subjective visual vertical/horizontal, SVV/SVH) and assess its clinical application for peripheral unilateral vestibular compensation.69 cases of acute peripheral unilateral vestibular dysfunction patients (case group) accepted SVV/SVH, spontaneous nystagmus (SN), caloric test (CT) and other vestibular function tests. 49 healthy people (control group) accepted SVV/SVH only. SVV/SVH, SN and unilateral weakness (UW) were selected as for the observation indicators. The correlations between SVV/SVH, SN, UW and courses were investigated respectively, as well as the characteristic of SVV/SVH, SN in period of vestibular compensation.Among case group SVV, SVH positive in 42 patients(60.9%) and 44 patients(63.8%), the absolute values of the skew angle were in the range between 2.1°-20.0°, 2.1°-22.2°. Skew angles of SVV/SVH in control were in the range between -1.5°-2.0° and -2.0°-1.6°, and had no statistical significance with case group(t=5.336 and 5.864, P0.05). SN-positive 28 cases (40.6%), the range of intensities at 2.4°-17.1°; UW-positive 50 cases (72.5%). In case group, positive correlation between SVV and SVH(r=0.948, P=0.00), negatively correlated between SVV/SVH and SN respectively(r values were -0.720, -0.733, P values were 0.00), no correlation between the skew angle of SVV/SVH, strength of SN and UW value(r values were 0.191, 0.189, and 0.179, P0.05), there was no correlation between the absolute value of SVV, SVH, SN, UW with the duration (rs values were -0.075, -0.065, -0.212, and 0.126, P0.05).Subjective visual gravity can be used not only to assess the range of unilateral peripheral vestibular dysfunction, but also help assess the static compensatory of otolithic, guidance and assessment of vestibular rehabilitation.

To explore the clinical values of Sensory Organization Test (SOT) of dynamic posturography in the diagnosis of peripheral vertigo.A total of 112 patients with peripheral vertigo were retrospectively analyzed. All the patients firstly underwent the inspection of SOT followed by caloric test. The results were conducted a comparative analysis. Assessments of SOT evaluated the patient's effective use of visual, vestibular, and somatosensory information for balance control during a variety of changing task conditions. The unilateral weakness was selected as assessment parameter of caloric test. Fourty-two healthy subjects were selected as control group underwent the dynamic posturography.Among the 42 cases of control group, results of SOT in dynamic posturography were normal. The SOT composite scores owned a significant difference between control and peripheral vertigo subjects. Among the 112 cases with peripheral vertigo, results of SOT in dynamic posturography were abnormal in 37 cases, with a sensitivity of 33.0%; caloric test was abnormal in 72 cases, with a sensitivity of 64.3%. There existed a significant difference between dynamic posturography and caloric test.SOT is a key test in dynamic posturography that reflects the balance reconstruction after peripheral injury, and provides information about the integration and proportion of the visual, proprioceptive, and vestibular components of balance.

The aim of this study was to evaluate the effects of obstructive sleep apnea-hypopnea syndrome (OSAHS) on semicircular canal function.By means of a series prospective study at Department of Otolaryngology Head and Neck Surgery of our hospital, the study was performed on 77 patients suffering from OSAHS in a period from 2012 to 2014, who underwent polysomnography (PSG) and caloric test. The maximal slow-phase velocity (SPV) and unilateral weakness (UW) were used to measure the vestibular function. Severity of OSAHS was evaluated by the lowest oxygen saturation (LSaO₂) and apnea hypopnea index (AHI). The SPV after cool was signed, warm test was performed for each ear, and the sum of left ear SPV were calculated, and then, the SPV of right ear was counted as the same way. Finally, the relationships between LSaO₂, AHI, age, BMI, and SPV of caloric test were analyzed.Caloric vestibular tests in the 77 OSAHS patients demonstrated abnormal findings in 52 patients (67.5%) and normal vestibular functions in the remaining 25 patients (32.5%). Of the 52 patients with an abnormal test result, 16 (20.8%) patients had unilateral vestibular hyporeflexia and 36 (46.7%) patients revealed a bilateral vestibular hyporeflexia. There was no linear relationship between AHI, age, BMI with SPV of caloric test (P0.05). The SPV had significant difference between Lower LSaO₂group (LSaO₂50%) and higher LSaO₂group (LSaO₂≥ 80%) (P0.05). LSaO₂was lower in patients undertaken bilateral vestibular hyporeflexia.OSAHS patients with long-term intermittent hypoxia can disturb the vestibular organs and reduce semicircular canal function. The heavier hypoxemia will lead to the lower reflex of semicircular canal, with the heavier degree of hypoxemia, and the bilateral horizontal semicircular canal involvement may also be higher at the same time. Due to the effect of vestibule centre compensatory, OSAHS patients lack of dizziness and symptoms from balance disturbances such as typically acute vestibular damage.

To discuss the video head impulse tests (vHIT) application values in assessment of the vestibular nerves, function in sudden deafness patients with vertigo.There were 60 cases (120 ears) of healthy volunteers as control group, and 182 cases (182 ears) of sudden deafness with vertigo patients as study group. The study group received vHIT and caloric test, and the control group received vHIT. Functions of vestibular superior and inferior nerves were analyzed by the gains of vHIT and the nystagmus, s unilateral weakness of caloric test, with SPSS17.0 software.The values of vHIT-G of the six semicircular canals in the control group were normal distribution and no statistical significance among them (F = 0.005, P = 1.000). The vHIT-G averages of both sides of anterior, horizontal and posterior semicircular canals were (15.20 ± 11.00) %, (15.30 ± 13.30) %, and (15.15 ± 14.72) % respectively. In the study group, the vHIT-G of the affected side were (21.73 ± 14.84) %, (21.20 ± 28.24) %, and (19.22 ± 23.50) %, with normal distribution, and in which statistical significance was detected comparing with those in the control group (P0.05). The positive rates were 26.9% (49/182) in vHIT, 70.3% (128/182) in caloric test. Significant difference (P0.05) was observed between vHIT and caloric test examined by chi-square test. According to the results of vHIT, there were 15 cases (8.2%) damaged vestibular superior and inferior nerves areas, 19 cases (10.4%) damaged the superior vestibular nerve area, and 15 cases (8.2%) damaged the inferior vestibular nerve area. In combination with caloric test results, it was shown that there were 29 cases (15.9%) damaged vestibular superior and inferior nerves areas, 101 cases (55.5%) damaged the superior vestibular nerve area, and 1 case (0.5%) damaged the inferior vestibular nerve area.vHIT can assess the function of six semicircular canals and illustrate high frequency of vestibular nerves. Caloric test combined with vHIT have more advantages to comprehensive assess vestibular damage of sudden deafness patients with vertigo.

To investigate the clinical significances and formation mechanism by analyzing the characteristics of the reverse phase nystagmus parameters from benign paroxysmal positional vertigo (BPPV) positioning test.There were 183 cases with BPPV, including 108 cases (59.0%) of posterior semicircular canal canalithiasis, 55 cases (30.1%) of horizontal semicircular canal canalithiasis, and 15 cases (8.2%) of horizontal and posterior semicircular canal cupulolithiasis and 5 cases (2.7%) of anterior semicircular canalithiasis . The video-nystagmography was utilized in positioning tests to induce nystagmus. The direction, intensity, time parameters characteristic of vertical nystagmus in Dix-Hallpike test and horizontal nystagmus in roll test were analyzed and compared.There were no reversal phase nystagmus in 15 cases of semicircular canal cupulolithiasis and 5 cases of anterior semicircular canalithiasis. After the disappearance of vertical nystagmus which induced by hanging position (the first phase nystagmus) in 108 cases of posterior semicircular canalithiasis of Dix-Hallpike test, there was 54 cases(50.0%) of posterior semicircular canal canalithiasis displayed downward vertical nystagmus (reverse phase nystagmus) . The latency, duration time and intensity of the first phase nystagmus and reverse phase nystagmus were [(2.00 ± 1.10) s, (3.54 ± 1.42) s], [ (16.27 ± 4.95) s, (61.65 ± 33.69)s] and [ (51.80 ± 25.25) °/s, (10.65 ± 6.29)°/s] respectively; 43 cases(78.2%) of horizontal semicircular canal canalithiasis displayed the opposite to turning head (reverse phase nystagmus) after the horizontal nystagmus, similar with turning head disappeared in Roll test. The latency, duration time and intensity of the first phase of nystagmus and reverse phase nystagmus were [ (1.67 ± 1.07) s, (3.57 ± 1.89)s], [ (25.19 ± 9.74) s, (70.48 ± 40.26)s] and [ (68.47 ± 30.18) °/s, (11.22 ± 8.78)°/s] respectively. Comparing with the latency, duration time, intensity of first phase nystagmus and reverse phase nystagmus of posterior and horizontal semicircular canal canalithiasis, the differences had statistical significances (P0.05). Comparing with the first phase nystagmus of reverse phase and no reverse phase nystagmus canalithiasis, the difference of nystagmus intensity had statistical significances (P0.05); but the differences of latency and duration of nystagmus had no significant difference (P0.05).It is common in PSC-Can and HSC-Can patients that reverse phase nystagmus is one of the clinical features of canalithiasis. It appears in side head position of Rolling test or the hanging of Dix- Hallpike test. More power of the first phase nystagmus has, reverse phase nystagmus will be induced much easier. In comparison of the reverse phase nystagmus, the first phase nystagmus has the shorter incubation and duration, but it has more power. It is helpful to avoid interruptions of clinical statolith positioning and reset since we recognize the reverse phase nystagmus. The mechanism might be similar to the vestibular mirror image nystagmus. It is another form of the vestibular mirror image nystagmus in BPPV patients.