Comparative utility of vestibular function tests in patients with peripheral and central vestibular dysfunction

Area of Science:

• Neurology
• Otolaryngology
• Vestibular System Function

Background:

• Peripheral vestibulopathy diagnosis relies on bithermal caloric irrigation, video head impulse test (vHIT), and rotational testing.
• The comparative clinical utility of these tests for differentiating peripheral vestibulopathy remains debated.

Purpose of the Study:

• To evaluate if combining vestibular tests improves diagnostic accuracy compared to single tests.
• To determine the correlation between abnormal results across different vestibular tests.

Main Methods:

• Retrospective analysis of data from 150 patients across two academic medical centers (2016-2022).
• Inclusion of patients evaluated with bithermal caloric irrigation, vHIT, and rotational testing.

Main Results:

• No single test significantly outperformed others in predicting peripheral vestibular damage.
• Combining vHIT with caloric or rotational testing significantly improved diagnostic utility (p=0.007, p=0.039).
• Caloric and rotational tests showed high sensitivity and specificity; vHIT had high specificity but low sensitivity. Test results did not correlate (p>0.05).

Conclusions:

• Vestibular function tests possess comparable diagnostic utility but offer distinct advantages.
• Caloric and rotational testing are suitable for screening peripheral vestibular damage.
• vHIT is best utilized as a confirmatory diagnostic tool for peripheral vestibulopathy.