Horizontal VOR function shows frequency dynamics in vestibular schwannoma

Autor: Ralf Helbig, Leif Erik Walther, Julia Blödow, Alexander Blödow, M. Bloching
Rok vydání: 2014
Předmět:
Zdroj: European Archives of Oto-Rhino-Laryngology. 272:2143-2148
ISSN: 1434-4726
0937-4477
DOI: 10.1007/s00405-014-3042-2
Popis: The objective of this retrospective study was to investigate the horizontal vestibulo-ocular reflex (hVOR) pathway with caloric test (low-frequency hVOR) and video head impulse test (vHIT) (high-frequency hVOR) in patients with sporadic vestibular schwannoma (69 patients, 27-86 years, mean age 58.1 years) and to compare both test methods in terms of their sensitivity and specificity to detect a retrocochlear lesion. Test results with a unilateral weakness (UWCaloric)25 % (caloric test) or a Mean-GainvHIT0.79/asymmetry ratio of Gain (AR-GainvHIT)8.5 % and accompanied refixation saccades (vHIT) were considered abnormal. The overall sensitivity of the caloric test was 72 %. The evaluation of AR-GainvHIT detected more abnormal cases than did Mean-GainvHIT (44 vs. 36 %). In up to 4 %, a normal caloric test result was related to an abnormal vHIT. There was only a moderate correlation of UWCaloric and AR-GainvHIT (r = 0.54, p0.05) with a linear regression line intercept/slope of 32.2/0.9 (p0.05). Receiver operating characteristics curve analysis exhibited at a UWCaloric of 50 % a vHIT sensitivity/specificity/positive predictive value/negative predictive value of 0.45/0.9/0.94/0.42. Vestibular testing at varying frequencies provides deeper insights into hVOR function and is helpful in detecting a cerebello-pontine lesion. Whereas caloric test yields a high sensitivity for nerve dysfunction, vHIT test reveals a remaining function of hVOR in the high-frequency range.
Databáze: OpenAIRE
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