To characterize video head impulse testing (vHIT) in definitive Menière’s disease and to investigate the relationship between vHIT results and other audiovestibular function tests.
Fifty-four patients with certain Menière’s disease, that is, patients with clinically definite Menière’s disease and endolymphatic hydrops visualized by locally enhanced inner ear MR imaging, were recruited for this study. All patients underwent vHIT. The vestibular-ocular reflex gain at 60 ms and refixation saccades were the outcome parameters measured. Saccades were characterized by determining the saccade frequency, their mean latency, and their mean velocity.
Seven of 54 patients had bilateral normal vHITs. Clearly pathologically vHITs with decreased gain and refixation saccades were observed in further seven patients. The majority of patients exhibited vHITs with refixation saccades but normal gain. Saccades mostly occurred bilaterally. There was no correlation between vHIT gain or saccades and caloric irrigation, cervical vestibular evoked myogenic potential or audiometry for Menière’s ears. Furthermore, vHIT gain or saccades correlated neither with age nor with the duration of the disease.
Pathological low vHIT gain values are rarely observed in patients with certain Menière’s disease, while refixation saccades occur very frequently. In the majority of patients, saccades occur bilaterally. In Menière’s disease, in contrast to vestibular neuritis, there is no compensatory decrease of saccade latency over time.
German Center for Vertigo and Balance Disorders and Department of Otorhinolaryngology - Head and Neck Surgery, Grosshadern Medical Center, University of Munich, Munich, Germany.
ACKNOWLEDGMENTS: The authors are grateful to Ms. Beatrice Lentge for excellent technical assistance, to Prof. Birgit Ertl-Wagner for excellent collaboration in locally enhanced inner ear MR imaging and Dr. Nadine Lehnen for helpful discussions on vestibular-ocular reflex physiology.
This study was supported by the Federal German Ministry of Education and Research (grant No. 01EO1401).
The authors have no conflicts of interest to declare.
Address for correspondence: Claudia Jerin, German Center for Vertigo and Balance Disorders and Department of Otorhinolaryngology - Head and Neck Surgery, University of Munich, Grosshadern Medical Center, Marchioninistrasse 15, 81377 Munich, Germany. E-mail: email@example.com
Received April 18, 2017; accepted March 16, 2018.