[Clinical studies on the furosemide VOR test]

Area of Science:

• Otolaryngology
• Neuroscience
• Vestibular System Physiology

Context:

• Vestibular endolymphatic hydrops is a condition characterized by fluid imbalance in the inner ear.
• Accurate detection of hydrops is crucial for diagnosing and managing vestibular disorders such as Meniere's disease.
• Current diagnostic methods may have limitations in sensitivity and specificity for fluctuating hydrops.

Purpose:

• To evaluate the efficacy of the furosemide vestibular test (FVOR) in detecting vestibular endolymphatic hydrops.
• To assess the diagnostic performance of FVOR in patients with Meniere's disease, delayed endolymphatic hydrops, and syphilitic labyrinthitis.
• To determine the utility of FVOR for monitoring treatment response and disease progression.

Summary:

• The furosemide vestibular test (FVOR) measures the directional preponderance of the VOR gain (VOR-DP%) before and after furosemide injection.
• Positive FVOR responses (>= 10% change in VOR-DP%) were observed in 51% of Meniere's disease patients, 52% with delayed endolymphatic hydrops, and 70% with syphilitic labyrinthitis.
• FVOR showed a negative shift post-surgery in 67% of patients with reduced vertigo, indicating its utility in monitoring treatment.

Impact:

• The FVOR test demonstrates high diagnostic accuracy for vestibular endolymphatic hydrops, particularly in Meniere's disease.
• It serves as a valuable tool for detecting and monitoring fluctuating hydrops without causing adverse inner ear side-effects.
• Combined with other tests, FVOR enhances the detection rate of endolymphatic hydrops, improving patient management.