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Testing of all Six Semicircular Canals with Video Head Impulse Test Systems
Published on: April 18, 2019
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How Good Are We in Evaluating a Bedside Head Impulse Test?
Athanasia Korda1, John Patrick Carey2, Ewa Zamaro1
1University Department of Otorhinolaryngology, Head and Neck Surgery, lnselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Ear and Hearing
|November 2, 2020
Summary
Saccade amplitude is key for detecting corrective saccades during the head impulse test (HIT) in patients with vestibular hypofunction. Larger saccade amplitudes significantly increase detection probability, while latency and VOR gain play minor roles.
Area of Science:
- Neuroscience
- Ophthalmology
- Audiology
Background:
- The head impulse test (HIT) is crucial for assessing vestibular-ocular reflex (VOR) function.
- Detecting corrective saccades during HIT is challenging for clinicians.
- Vestibular hypofunction impairs the VOR, necessitating accurate diagnostic tools.
Purpose of the Study:
- To evaluate the likelihood of expert clinicians detecting corrective saccades during horizontal HITs.
- To identify key parameters influencing saccade detection in patients with vestibular hypofunction.
Main Methods:
- Prospective observational cohort study involving 365 horizontal HITs from seven patients with deficient VOR.
- Simultaneous recording of HITs using video-oculography as the gold standard.
- Analysis of saccade latency, amplitude, head velocity, and VOR gain.
Main Results:
- Saccade amplitude was the most significant factor for saccade detection (p < 0.001).
- The probability of saccade detection increased with larger saccade amplitudes (OR 1.77 per degree).
- HITs toward the pathological side showed an eightfold higher probability of saccade detection (p = 0.029).
Conclusions:
- Saccade amplitude is the primary determinant for accurate saccade detection in clinical HITs.
- Saccade latency and VOR gain have a minimal impact on detection probability, contrary to previous assumptions.
