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J Am Acad Audiol 2021; 32(05): 283-289
DOI: 10.1055/s-0041-1723039
Research Article

Agreement between the Skull Vibration-Induced Nystagmus Test and Semicircular Canal and Otolith Asymmetry

Yue Zhang
1   Vestibular and Balance Program, Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota
2   Department of Rehabilitation Medicine, Tianjin Huanhu Hospital, Tianjin, China
,
Jamie Soper
3   MercyOne Waterloo Medical Center, ENT/Allergy Care, Waterloo, Iowa
,
Christine M. Lohse
4   Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
,
Scott D.Z. Eggers
5   Vestibular and Balance Program, Department of Neurology, Mayo Clinic, Rochester, Minnesota
,
Kenton R. Kaufman
6   Motion Analysis Laboratory, Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
,
Devin L. McCaslin
1   Vestibular and Balance Program, Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota
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Abstract

Background How significant asymmetries in otolith organ function in the presence of symmetrical and asymmetrical semicircular canal function influence skull vibration-induced nystagmus testing (SVINT) has not been well described.

Purpose The aim of the study is to examine the agreement between SVINT and caloric testing, ocular vestibular-evoked myogenic potentials (oVEMP), and cervical vestibular-evoked myogenic potentials (cVEMP) for detecting asymmetric vestibular function.

Research Design This is a retrospective study of patients presenting with the chief complaint of vertigo, dizziness, or imbalance.

Study Sample A total of 812 patients were studied with a median age at testing of 59 years (interquartile range 46–70; range 18–93) and included 475 (59%) women.

Intervention Either the monothermal warm caloric test or alternate binaural bithermal caloric test, oVEMP, and cVEMP tests were administered to all patients. All patients underwent the SVINT prior to vestibular laboratory testing.

Data Collection and Analysis Agreement between tests categorized as normal versus abnormal was summarized using percent concordance (PC). Sensitivity and specificity values were calculated for SVINT compared with other tests of vestibular function.

Results There was higher agreement between ipsilateral and contralateral SVINT with the caloric test (PC = 80% and 81%, respectively) compared with oVEMP (PC = 63% and 64%, respectively) and cVEMP (PC = 76% and 78%, respectively). Ipsilateral and contralateral SVINT showed higher sensitivity for the caloric test (sensitivity = 47% and 36%, respectively) compared with oVEMP (sensitivity = 26% and 21%, respectively), or cVEMP (sensitivity = 33% vs. 27%, respectively). Specificity of SVINT was high (>80%) for all assessments of vestibular function.

Conclusion The presence of SVIN is a useful indicator of the asymmetry of vestibular function between the two ears when making judgments about semicircular canal asymmetry but is less sensitive to asymmetries in otolith organ function.

Keywords

SVINT - caloric test - oVEMP - cVEMP


Publication History

Received: 02 July 2020

Accepted: 06 November 2020

Article published online:
19 April 2021

© 2021. American Academy of Audiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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