Related Experiment Video
Updated: Apr 30, 2026
10:12
Three Dimensional Vestibular Ocular Reflex Testing Using a Six Degrees of Freedom Motion Platform
Published on: May 23, 2013
15.8K
Horizontal VOR function shows frequency dynamics in vestibular schwannoma
Alexander Blödow1, Julia Blödow, Marc Boris Bloching
1Department of Otorhinolaryngology, Head and Neck Surgery and Communication Disorders, HELIOS-Clinic Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany, alexander.bloedow@helios-kliniken.de.
Summary
The caloric test shows high sensitivity for vestibular schwannoma nerve dysfunction, while the video head impulse test (vHIT) reveals remaining horizontal vestibulo-ocular reflex (hVOR) function at high frequencies.
Area of Science:
- Neurology
- Otolaryngology
- Neuroscience
Background:
- Vestibular schwannomas are tumors affecting the vestibulocochlear nerve.
- The horizontal vestibulo-ocular reflex (hVOR) is crucial for stabilizing gaze during head movements.
- Assessing hVOR function at different frequencies can aid in diagnosing retrocochlear lesions.
Purpose of the Study:
- To investigate the horizontal vestibulo-ocular reflex (hVOR) pathway using caloric tests (low-frequency) and video head impulse tests (vHIT) (high-frequency) in patients with sporadic vestibular schwannoma.
- To compare the sensitivity and specificity of caloric tests and vHIT in detecting retrocochlear lesions caused by vestibular schwannoma.
Main Methods:
- Retrospective study of 69 patients with sporadic vestibular schwannoma (age 27-86 years).
- Caloric testing assessed low-frequency hVOR, with unilateral weakness (UWCaloric) >25% considered abnormal.
- Video head impulse test (vHIT) assessed high-frequency hVOR, with Mean-GainvHIT <0.79 or asymmetry ratio of Gain (AR-GainvHIT) >8.5% and refixation saccades considered abnormal.
Main Results:
- The overall sensitivity of the caloric test was 72%.
- AR-GainvHIT identified more abnormal cases (44%) than Mean-GainvHIT (36%).
- A moderate correlation (r=0.54) was found between UWCaloric and AR-GainvHIT.
Conclusions:
- Vestibular testing at varying frequencies provides deeper insights into hVOR function.
- Caloric testing demonstrates high sensitivity for detecting nerve dysfunction in vestibular schwannoma.
- vHIT is valuable for revealing residual hVOR function in the high-frequency range, complementing caloric test findings.
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