[Utricular function. Correlation of three investigations carried out in routine practice]

Area of Science:

• Otolaryngology
• Neurotology
• Vestibular System Diagnostics

Background:

• Diagnosing vestibular disorders requires otolaryngology (ENT) expertise.
• Evaluating otolithic function, particularly the utricle, remains challenging.
• Current methods like c-VEMP assess saccular function, while utricular function assessment is less established.

Purpose of the Study:

• To evaluate the agreement between different diagnostic tools for assessing utricular function in ENT-relevant vestibular disorders.
• To determine the reliability of ocular vestibular evoked myogenic potentials (o-VEMP) and the turnover maneuver in diagnosing utricular dysfunction.
• To compare these methods with subjective visual vertical (SVV) registration.

Main Methods:

• 100 unselected patients with dizziness were prospectively examined.
• Standard vestibular diagnostics were performed, alongside the turnover maneuver, o-VEMP recording, and SVV registration.
• Patients attended a specialized vestibular outpatient department.

Main Results:

• 62% of patients showed agreement across all three methods for assessing utricular function.
• An additional 6% agreed between the turnover maneuver and o-VEMP.
• High conformity was observed in patients with non-vestibular dizziness, psychogenic vertigo, and Menière's disease.

Conclusions:

• O-VEMP recordings and the turnover maneuver during caloric testing are valuable for assessing utricular function, especially positive function.
• While 68% conformity exists between o-VEMP and the turnover maneuver, they provide strong indications rather than complete proof of dysfunction alone.
• SVV is easy to register but primarily discriminates utricular function in acute disorders.