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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 analyze the occurrence and probable etiological factors of benign paroxysmal positional vertigo (BPPV).one hundred and twenty four BPPV cases were inquired histories, classified into different groups and analyzed relevant diseases. All patients were taken Caloric tests before Canal repositioning procedure, and compared the differences of unilateral weakness (UW) and semicircular canal involved between BPPV patients with and without relevant diseases.There were 97 (78.2%) patients with relevant diseases while 27 (21.8%) without. Ninety-two (74.2%) patients with abnormal UW. To compare the normal and abnormal UW, posterior canal and lateral canal with abnormal UW values, unilateral or bilateral of abnormal UW values, consistency of abnormal UW side and BPPV side between BPPV patients with and without relevant diseases, there were no significant differences (Chi-square values were 0.000, 0.000, 0.306, 0.027, P0.05).BPPV patients with relevant diseases are common, which mainly occurs in middle-aged or aged people and female. Otolith ecclesiis and dysfunction of semicircular canal may have the same etiological factors. Caloric tests may do help to analyze the BPPV etiological factors.

To analyze the result of smooth pursuit test (SPT) in unilateral vestibular peripheral vertigo and investigate its influencing factors.Smooth pursuit test (SPT) and spontaneous nystagmus (SN) were examined in one hundred and eighty-five patients with unilateral peripheral vertigo (case group) and 51 normal persons (control group) by Video-Nystagmography (Synapsis, France), and the gain of SPT and SN were selected as the observation parameters in order to analyze the waveform and gain of SPT and the relativity between SN and the gain of SPT.Of the 185 patients, 105 (56.8%), 72 (38.9%) and 8 (4.3%) cases produced I , II and III waveforms respectively. Of these patients, 58 (31.4%) demonstrated SN and none had IV waveform. While of 51 normal persons, 38 (74.5%), 13 (25.5%) persons produced I and II waveforms respectively and there were no III, IV waveforms or SN. There was statistical significance between the strong and weak gain of SPT in these two groups. Weak gain was significantly different between two groups. The strong and weak gain of SPT in case group were 0.86 +/- 0.06, 0.80 +/- 0.06; 0.78 +/- 0.09, 0.65 +/- 0.1; 0.68 +/- 0.13, 0.45 +/- 0.12. The relativity between SN and the gain of SPT was positive when they had same direction (r(s) = -0.63, P0.05) and negative when opposite (r(s) = 0.34, P0.05).I , II, III three waveforms of SPT could appear in unilateral vestibular peripheral vertigo and the corresponding gains are gradually decreasing. SN is the influencing factor of SPT.

To analyze the value of positioning diagnosis of VNG (Videonystagmograph) in patients with benign paroxysmal positional vertigo (BPPV).One hundred and twenty-six patients with BPPV were enrolled in this retrospective study. Their positional nystagmus recorded by VNG in Dix-Hallpike and roll tests were analyzed to summarize the characteristics of nystagmus on nystagmography of various BPPV.Of 126 patients with BPPV diagnosed in our center, the posterior semicircular canals (PSC) were involved in 98 patients (77.8%), whereas the horizontal semicircular canal (HSC) and anterior semicircular canal (ASC) were involved in 17 (13.5%) and 5 (3.9%), respectively. Six patients (4.8%) confirmed combined-BPPV had HSC-BPPV and ipsilateral PSC-BPPV. Twenty-eight patients with PSC-BPPV had reversal phase on nystagmography. The nystagmus of patients with P/ASC-canalithiasis showed upward/downward on the vertical phase of nystagmography and orientated the opposite side on horizontal phase in the head hanging position, and the nystagmus reversed when returned to sit. Nystagmus on horizontal phase could be provoked when the head turned to both sides of the roll tests in patients with HSC-BPPV. If the nystagmus and the head-turning shared the same direction, then HSC-canalithiasis was confirmed, and the direction of the head-turning which provoked the stronger nystagmus indicates the lesion side. If the nystagmus and the head-turning had the opposite direction, then HSC-cupulolithiasis was confirmed, and the direction of the head-turning which provoked the weaker nystagmus indicates the lesion side.Positional nystagmus can be recorded objectively using VNG, According to which positioning the semicircular canal involved would be easier and more accurate. The recording conserved also could be helpful for clinical diagnosis and repositioning of BPPV.

To investigate the screening value and the reliability of the monothermal caloric tests (MCT) in evaluating vestibular function.One thousand and four hundred and six vertigo patients were divided into two groups. Seven hundred and five cases were stimulated by different temperature air from cold to warm. The caloric test sequence of other 701 cases was opposite. The first stimulated cold or warm air test was regarded as monothermal cold caloric test (MCCT) or monothermal warm caloric test (MWCT). The unilateral weakness (UW) and directional preponderance (DP) of the bithermal caloric tests (BCT) and the UW of the MCT were calculated. By defining the BCT results as the standard, the sensitivity, specificity, Youden's index and kappa were calculated.Four hundred and twenty-eight showed abnormal BCT and MCCT. One hundred and forty-five showed normal BCT and MCCT. 85, 47 showed isolated abnormal BCT and abnormal MCCT respectively. The sensitivity of the MCCT was 83.4%, specificity was 75.5%, Youden's index was 0.589 and kappa was 0.555 (P0.01). Four hundred and twenty-nine showed abnormal BCT and MWCT, 130 showed normal BCT and MWCT. 82, 60 showed isolated abnormal BCT and abnormal MWCT respectively. The sensitivity of the MWCT was 84.0%, specificity was 68.4%, Youden's index was 0.524 and kappa was 0.505 ( P0.01). The sensitivity of the MCCT and MWCT were 86.9% and 86.9% respectively when cases accompanied by spontaneous nystagmus (SN) were excluded. The sensitivity of the MCCT and MWCT were 89.3% and 88.1% respectively when cases with abnormal DP were excluded.The high false-positive and false-negative rate of the MCT limit the usefulness as a screening test due to the influence of DP and SN.