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Six-canal video head impulse test in patients with labyrinthine and retrolabyrinthine pathology: detecting vestibulo-ocular reflex deficits

Published online by Cambridge University Press:  16 May 2022

G Kontorinis Open the ORCID record for G Kontorinis [Opens in a new window] ,
H Tailor Open the ORCID record for H Tailor [Opens in a new window] ,
T Tikka  and
M A M Slim
G Kontorinis*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
H Tailor
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
T Tikka
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
M A M Slim
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
*
Author for correspondence: Prof Georgios Kontorinis, Department of Otorhinolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, Scotland, UK E-mail: gkontorinis@gmail.com
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Abstract

Background

Abnormal gains in six-canal video head impulse test are attributed to semi-circular canal deficits. However, as video head impulse test responses are linked to the vestibulo-ocular reflex, it was hypothesised that abnormal gains can be caused by vestibulo-ocular reflex pathway deficits.

Methods

This study compared video head impulse test gains in 20 patients with superior semi-circular canal dehiscence (labyrinthine cause) and 20 side- and gender-matched patients with vestibular schwannomas (retrolabyrinthine cause), and investigated correlations between them (Mann–Kendall trend test).

Results

Vestibular schwannoma but not superior semi-circular canal dehiscence was significantly associated with abnormal lateral (odds ratio = 9.00 (95 per cent confidence interval = 1.638–49.44), p = 0.011) and posterior (odds ratio = 9.00 (95 per cent confidence interval = 2.151–37.659), p = 0.003) canal status. In vestibular schwannoma patients, there was a statistically significant degree of dependence between all ipsilesional canal video head impulse test gains; such dependence was not observed in superior semi-circular canal dehiscence.

Conclusion

Vestibulo-ocular reflex gains differ in patients with labyrinthine and retrolabyrinthine disease; this suggests that abnormal gains can indicate deficits not only in the semi-circular canals but also elsewhere along the vestibulo-ocular reflex pathway.

Keywords

Acoustic NeuromaHead Impulse TestLabyrinthVertigoVestibulo-Ocular Reflex
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 4 , April 2023 , pp. 398 - 403
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Prof G Kontorinis takes responsibility for the integrity of the content of the paper

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