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Definición de umbrales de diagnóstico para la disociación entre la prueba calórica y el vHIT en la enfermedad de
Tae Uk Cheon1, Ju Ha Park1, Ji Seop Lee1
1Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Frontiers in neurology
|September 4, 2025
Resumen
La disociación entre las pruebas calóricas y las pruebas de impulso de video de la cabeza (vHIT) ayuda a diagnosticar Ménière
Área de la Ciencia:
- Neurología
- Otorrinolaringología
- El sistema vestibular
Sus antecedentes:
- El diagnóstico de la enfermedad de Ménière (MD) es un desafío debido a la superposición de síntomas con otros trastornos vestibulares.
- El diagnóstico preciso es crucial para el manejo eficaz y los resultados del paciente.
Objetivo del estudio:
- Evaluar el valor diagnóstico de las pruebas de función vestibular para diferenciar la enfermedad de Ménière de otros trastornos vestibulares.
- Para evaluar la utilidad diagnóstica de la disociación entre los resultados de la prueba calórica y la prueba de impulso de vídeo de la cabeza (vHIT) en MD.
Principales métodos:
- Análisis retrospectivo de 195 pacientes: 51 con MD, 112 con schwannoma vestibular (VS) y 32 con vértigo posicional paroxístico benigno (VPPB).
- Función vestibular evaluada mediante pruebas calóricas y vHIT.
- La disociación se define como una respuesta calórica anormal (pareces de canal > 25%) con una ganancia normal de vHIT (> 0,80).
Principales resultados:
- La disociación fue significativamente más frecuente en MD (56,9%) en comparación con VS (25,0%) y BPPV (9,4%) (p < 0,001).
- La disociación efectivamente distinguió MD de BPPV (DOR = 12.74) pero mostró una utilidad limitada para diferenciar MD de VS (DOR = 3.96).
- La paresis del canal (CP) por sí sola diferenció a la MD de la BPPV, pero no a la VS.
Conclusiones:
- La disociación entre los resultados calóricos y vHIT es un indicador de diagnóstico valioso para la enfermedad de Ménière.
- Este patrón de disociación ayuda a distinguir MD de BPPV, pero su utilidad para diferenciar MD de VS requiere más investigación.
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