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Updated: Sep 26, 2025
Testing of all Six Semicircular Canals with Video Head Impulse Test Systems
Published on: April 18, 2019
Comparison between caloric and video-head impulse tests in Ménière's disease and vestibular neuritis
András Molnár1, Stefani Maihoub1, László Tamás1
1Faculty of Medicine, Department of Otolaryngology and Head and Neck Surgery, Semmelweis University, Budapest, Hungary.
Objective:
To compare the diagnostic accuracies of air caloric testing with electronystagmography and the vHIT (video-head impulse test).
Design:
Prospective, controlled study.
Study Sample:
MD (Ménière's disease), 26; vestibular neuritis, 27; control, 56.
Results:
In MD, CP (canal paresis) was pathological in 88.5%, the GA (gain asymmetry) on vHIT was pathological in 65.3%, and the gain was abnormal in only one patient. The GA and CP, were significantly higher in the MD group than in the control group, indicating hypofunction of the horizontal canals in MD, whereas a hyperfunction may also occur. No correlation was observed between the results of the two tests for evaluating MD, suggesting that pathological outcomes of one test do not guarantee abnormalities on the other test. For vestibular neuritis, significantly higher CP (96.3%), GA (81.5%), and gain (51.9%) values were detected. A correlation was identified between the two tests for vestibular neuritis, indicating a similar diagnostic efficiency. The higher percentage of pathological GA versus pathological gain values indicates that the asymmetry may be more informative.
Conclusions:
The vHIT showed a higher specificity, whereas the caloric test a higher sensitivity. No correlation between the two methods was observed; therefore, the tests appear to provide complementary information.
Insights
The video-head impulse test (vHIT) and air caloric testing offer complementary diagnostic information for vestibular disorders. While vHIT shows higher specificity, caloric testing has greater sensitivity, with no direct correlation between their findings.
Area of Science:
- Vestibular Neuroscience
- Otolaryngology
- Diagnostic Imaging
Background:
- Vestibular disorders significantly impact quality of life.
- Accurate diagnosis relies on objective testing of the vestibular system.
- Air caloric testing and video-head impulse test (vHIT) are common diagnostic tools.
Purpose of the Study:
- To compare the diagnostic accuracy of air caloric testing (electronystagmography) with the vHIT.
- To evaluate the utility of these tests in differentiating Ménière's disease (MD) and vestibular neuritis from healthy controls.
Main Methods:
- A prospective, controlled study was conducted.
- Participants included patients with MD (n=26), vestibular neuritis (n=27), and healthy controls (n=56).
- Diagnostic accuracies of air caloric testing and vHIT were assessed.
Main Results:
- In MD, canal paresis (CP) was pathological in 88.5% and gain asymmetry (GA) on vHIT in 65.3%.
- Vestibular neuritis showed significantly higher CP (96.3%) and GA (81.5%) compared to controls.
- No correlation was found between caloric testing and vHIT in MD, suggesting complementary roles.
Conclusions:
- vHIT demonstrates higher specificity, while air caloric testing offers higher sensitivity.
- The tests provide complementary diagnostic information for vestibular pathologies.
- Gain asymmetry on vHIT may be more informative than absolute gain values.
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