The Dissociation of Video Head Impulse Test (vHIT) and Bithermal Caloric Test Results Provide Topological Localization of Vestibular System Impairment in Patients With “Definite” Ménière's Disease Purpose We report 3 patients with Ménière's disease and describe how the combination of audiometry, video head impulse testing, and caloric results may prove helpful in the diagnosis of Ménière's disease. Method Three patients with “definite” Ménière's disease were evaluated in a tertiary care medical center. Each patient ... Clinical Focus
Clinical Focus  |   March 01, 2015
The Dissociation of Video Head Impulse Test (vHIT) and Bithermal Caloric Test Results Provide Topological Localization of Vestibular System Impairment in Patients With “Definite” Ménière's Disease
 
Author Affiliations & Notes
  • Devin L. McCaslin
    Vanderbilt University Medical Center, Nashville, TN
  • Alejandro Rivas
    Vanderbilt University Medical Center, Nashville, TN
  • Gary P. Jacobson
    Vanderbilt University Medical Center, Nashville, TN
  • Marc L. Bennett
    Vanderbilt University Medical Center, Nashville, TN
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication.×
  • Correspondence to Devin L. McCaslin: devin.mccaslin@vanderbilt.edu
  • Editor and Associate Editor: Larry Humes
    Editor and Associate Editor: Larry Humes×
Article Information
Hearing Disorders / Balance & Balance Disorders / Clinical Focus
Clinical Focus   |   March 01, 2015
The Dissociation of Video Head Impulse Test (vHIT) and Bithermal Caloric Test Results Provide Topological Localization of Vestibular System Impairment in Patients With “Definite” Ménière's Disease
American Journal of Audiology, March 2015, Vol. 24, 1-10. doi:10.1044/2014_AJA-14-0040
History: Received August 25, 2014 , Revised September 29, 2014 , Accepted October 12, 2014
 
American Journal of Audiology, March 2015, Vol. 24, 1-10. doi:10.1044/2014_AJA-14-0040
History: Received August 25, 2014; Revised September 29, 2014; Accepted October 12, 2014
Web of Science® Times Cited: 3

Purpose We report 3 patients with Ménière's disease and describe how the combination of audiometry, video head impulse testing, and caloric results may prove helpful in the diagnosis of Ménière's disease.

Method Three patients with “definite” Ménière's disease were evaluated in a tertiary care medical center. Each patient underwent videonystagmography, horizontal canal video head impulse testing, and audiometry.

Results All 3 patients demonstrated moderate, flat, sensorineural hearing losses; significant caloric asymmetries; and bilaterally normal video head impulse testing. This pattern of findings suggests differential preservation of high-frequency function (video head impulse testing) with impairment of low-frequency function (unilaterally abnormal caloric test results) in these patients.

Conclusion Ipsilesional abnormal caloric testing in the presence of normal video head impulse testing is a pattern of findings observed in a cohort of patients who have “definite” Ménière's disease.

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