Screening methods for caloric testing

In order to evaluate the screening capacity and the reliability of monothermal caloric stimulation, the caloric results obtained in 272 patients have been reviewed. The results of a complete bithermal 4-test-set are compared with the results of the hot and cold stimulation considered separately. The supposition that a complete 4-test set is necessary only if the monothermal reaction shows significant asymmetry, is tested by determining how far this would lead to a correct evaluation compared with the final results obtained by the bithermal testing. The study shows that hot as well as cold monothermal screening would result in too many false positive as well as false negative findings. A test procedure consisting of an alternating bithermal stimulation is proposed as a technique for shortening the examination time. This technique has proven to be reliable and it is also more comfortable for the patient.