Open Access
CC BY-NC-ND 4.0 · Laryngorhinootologie 2022; 101(S 02): S243-S244
DOI: 10.1055/s-0042-1746884
Poster
Otology / Neurootology / Audiology: Neurootology / Vertigo

Evaluation of the diagnostic significance of result-combinations of well-established and new diagnostic tests for vestibular disorders

Authors

  • Stephan Ernst

    1   Universitätsklinikum Gießen und Marburg, Klinik für Hals-Nasen-Ohrenheilkunde Gießen

  • Marina Theis

    1   Universitätsklinikum Gießen und Marburg, Klinik für Hals-Nasen-Ohrenheilkunde Gießen

  • Claus Wittekindt

    2   Klinikum Dortmund, Klinik für HNO-Heilkunde Dortmund
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    Objective Besides the gold standard, the caloric reflex test, vertigo diagnosis is increasingly supplemented by the video head impulse test (vHIT) for all six semicircular canals of the vestibular organ. Therefore, the aim of this study is to evaluate the possible gain in diagnostic significance from the combination of different outcome parameters of the same and different apparative examination methods (calorics, vHIT).Methods Diagnostic significance was prospectively evaluated and compared using the target parameters of sensitivity (SEN), specificity (SPE), positive predictive value (PPV) and negative predictive value (NPV) based on a study collective of 42 healthy and 40 subjects with peripheral-vestibular pathology. Results Caloric testing achieved a SEN of 78% as single procedure and a SPE of 85%. The vHIT showed a SEN of 90% and a SPE of 86% in the triple combination of gain and gain asymmetry of the horizontal semicircular canals (vHITlat) and the gain of the anterior semicircular canals (gainant), if at least one of the three parameters was pathological. If all three parameters were pathologic, an SPE of 100% was achieved. For the posterior semicircular canals of the vHIT, there was no evidence of a significant difference between the groups (p>0.05). A maximal SEN and NPV of 100% was achieved by the combination of vHIT (vHITlat + gainant) and caloric testing. The combination of vHITlat alone and caloric testing established a SEN of 95%. Conclusion The vHIT can be preferred to caloric testing in the clinical routine of the diagnostic investigation of peripheral vestibular disorders. However, the combination of vHIT and caloric testing still appears superior to vHIT as a single test and therefore improves the certainty of diagnosis.


     

    Conflict of Interest

    The author declares that there is no conflict of interest.

    Publikationsverlauf

    Artikel online veröffentlicht:
    24. Mai 2022

    © 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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