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Updated: Aug 7, 2025
Testing of all Six Semicircular Canals with Video Head Impulse Test Systems
Published on: April 18, 2019
Normative values for the video Head Impulse Test in children without otoneurologic symptoms and their evolution
Rosana Rodríguez-Villalba1,2, Miguel Caballero-Borrego3,4
1Department of Otorhinolaryngology, Hospital Sant Joan de Déu, Barcelona, Spain.
Insights
Vestibulo-ocular reflex (VOR) gain in children increases with age, reaching adult levels by 7-10 years. This study provides crucial pediatric VOR data for the video Head Impulse Test.
Area of Science:
- Neuroscience
- Ophthalmology
- Pediatrics
Background:
- The video Head Impulse Test (vHIT) assesses semicircular canal function.
- Pediatric reference values for vHIT are limited.
- Understanding vestibulo-ocular reflex (VOR) development is essential.
Purpose of the Study:
- To determine pediatric reference values for VOR gain using vHIT.
- To explore VOR development across different pediatric age groups.
- To compare pediatric VOR gain with adult values.
Main Methods:
- Prospective, single-center study of 187 healthy children (3-16 years).
- Children grouped by age: 3-6, 7-10, and 11-16 years.
- VOR assessed using the EyeSeeCam video Head Impulse Test device.
Main Results:
- Lower horizontal canal VOR gain observed in the 3-6-year-old group compared to older children.
- No significant gain increase in horizontal canals from 7-10 to 11-16 years.
- No sex-based differences in VOR gain were detected.
Conclusions:
- Horizontal canal VOR gain increases with age in children up to 7-10 years.
- Pediatric VOR gain values align with adult norms by age 7-10 years.
- Establishes developmental norms for vHIT in children.
Purpose:
The video Head Impulse Test is routinely used to assess semicircular canal function in adults, but to date, pediatric reference values are scarce. This study aimed to explore the vestibulo-ocular reflex (VOR) in healthy children at different development stages and to compare the obtained gain values with reference to those in an adult population.
Methods:
This prospective, single-center study recruited 187 children from among patients without otoneurological diseases, healthy relatives of these patients, and staff families from a tertiary hospital. Patients were divided into three groups by age: 3-6 years, 7-10 years, and 11-16 years. The vestibulo-ocular reflex was assessed by video Head Impulse Test, using a device with a high-speed infrared camera and accelerometer (EyeSeeCam®; Interacoustics, Denmark).
Results:
We found a lower vestibulo-ocular reflex gain of both horizontal canals in the 3-6-year-old group when compared with the other age groups. No increasing trend was found in the horizontal canals from age 7-10 years to age 11-16 years, and no differences were found by sex.
Conclusion:
Gain values in the horizontal canals increased with age until children reached age 7-10 years and matched the normal values for adults.
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