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What does the dissociation between the results of video head impulse versus caloric testing reveal about the vestibular dysfunction in Ménière's disease?

Authors :
McGarvie, Leigh A.
Curthoys, Ian S.
MacDougall, Hamish G.
Halmagyi, G. Michael
Source :
Acta Oto-Laryngologica. Sep2015, Vol. 135 Issue 9, p859-865. 7p.
Publication Year :
2015

Abstract

Conclusion: It is suggested that the different results of rotational (video head impulse - vHIT) and caloric tests in patients with Ménière's disease (MD) may be a consequence of the physical enlargement of the membranous duct in the hydropic labyrinths in MD, causing a reduced response to caloric stimulation. Objectives: There have been reports that the results of two tests of semicircular canal function, the caloric response and the responses to vHIT do not agree. This retrospective study at a tertiary referral hospital examined this disagreement. Methods: This study reviewed the data of 22 patients who met the AAO-HNS criteria for MD and who had both caloric and vHIT testing. Results: There was a clear dissociation: patients with MD had a small or absent response to caloric stimulation of their affected ear, whilst their response to vHIT was in the normal range. Discussion: The accepted Gentine model of the mechanism of caloric stimulation could account for this dissociation: the increased diameter of the semicircular duct in hydropic labyrinths resulting in endolymph circulation within the duct itself and so a smaller thermally induced pressure across the cupula. The increased duct diameter will have little effect on responses to rotation. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00016489
Volume :
135
Issue :
9
Database :
Academic Search Index
Journal :
Acta Oto-Laryngologica
Publication Type :
Academic Journal
Accession number :
108561748
Full Text :
https://doi.org/10.3109/00016489.2015.1015606