Comparing Video Head Impulse Testing With Rotary Chair in Pediatric Patients: A Controlled Trial.

Area of Science:

• Pediatric Vestibular Assessment
• Oculomotor Function
• Neuro-otology

Background:

• Vestibular dysfunction in children can significantly impact development and quality of life.
• Accurate diagnostic tools are crucial for timely intervention in pediatric vestibular disorders.
• Rotary chair testing is a standard but time-consuming method for assessing vestibular function.

Purpose of the Study:

• To evaluate the efficacy of video head impulse testing (VHIT) in identifying vestibular loss in pediatric patients.
• To compare VHIT performance against rotary chair testing in children with abnormal vestibular function.
• To determine the diagnostic accuracy of VHIT for detecting vestibular impairment in a pediatric cohort.

Main Methods:

• Prospective, nonrandomized, controlled trial conducted at a tertiary children's hospital.
• Recruitment of 37 pediatric patients (3-18 years) undergoing both VHIT and rotary chair testing.
• Comparison of VHIT results between an experimental group (vestibular symptoms, abnormal rotary chair) and a control group (no symptoms, normal rotary chair).

Main Results:

• VHIT showed significantly reduced lateral semicircular canal gain in the experimental group compared to controls (P < .005).
• A VHIT lateral canal gain <0.85 or corrective saccades yielded 100% specificity and positive predictive value for vestibular loss.
• Sensitivity was 69.6% and negative predictive value was 66.7%, indicating limitations in detecting all cases.

Conclusions:

• VHIT is a valuable tool for detecting lateral semicircular canal impairment in children.
• The sensitivity of VHIT is limited when compared to rotary chair testing for pediatric vestibular assessment.
• Further research is needed to clarify the role of VHIT in diagnosing vertical canal dysfunction in pediatric patients.