Differences in semicircular canal function in the video head impulse test in patients in the chronic stage of sudden sensorineural hearing loss with vertigo and vestibular neuritis

Abstract

Background

Sudden sensorineural hearing loss with vertigo (SHLV) and vestibular neuritis (VN) can result in prolonged dizziness.

Objectives

This study aimed to compare the video head impulse test (vHIT) of patients with SHLV and VN.

Methods

Fifteen patients with SHLV and 21 patients with VN who visited the Vertigo/Dizziness Center of our hospital between December 2016 and February 2023 were included. vHIT was performed at the time of admission, and the VOR gain and catch up saccade (CUS) in the three types of semicircular canals (SCCs) were analyzed.

Results

Pathologic vHIT results were observed most frequently in the posterior SCC (73%), followed by lateral (53%) and anterior (13%) SCCs in the SHLV group. In contrast, pathologic vHIT results were observed most frequently in the lateral SCC (100%), followed by the anterior (43%) and posterior SCC (24%) SCCs in the VN group. Pathological vHIT results in the lateral and posterior SCC showed significant differences between the two groups, but for anterior SCC, no significant differences were found.

Conclusions and significance

Comparison of the two vHIT results revealed differences in the SCC dysfunction patterns. This may be due to the different pathophysiological mechanisms of the two vestibular disorders, which may result in prolonged vertigo.

Chinese Abstract

背景：突发感音神经性听力损失伴眩晕 (SHLV) 和前庭神经炎 (VN) 可导致长时间的头晕。

目的：本研究旨在比较 SHLV 和VN 患者的视频头脉冲测试 (vHIT)。

方法：纳入在2016年12月至2023年2月期间就诊于我院眩晕/头晕中心的15 名 SHLV 患者和 21 名 VN 患者。 入院时进行了vHIT, 分析了三种类型半规管（SCC）中的VOR 增益和补救扫视 (CUS)。

结果：对于SHLV 组, 病理 vHIT 结果最常见于SCC后部 (73%), 其次是外侧 (53%) 和前部 (13%) 。 相比之下, VN 组中, 病理 vHIT 结果最常见于SCC外侧(100%), 其次是前部 (43%) 和后部 (24%)。 SCC外侧和后部的病理 vHIT 结果显示两组之间存在显著差异, 但对于SCC前部, 没有发现显著差异。

结论和意义：两个 vHIT 结果的比较揭示了 SCC功能障碍模式的差异。 这可能是由于两种前庭障碍的病理生理机制不同所致, 这可能导致长时间眩晕。

Keywords:

• Vestibular neuritis
• idiopathic sudden sensorineural hearing loss with vertigo
• vestibulo-ocular reflex
• video head impulse test

Acknowledgements

We extend our heartfelt appreciation to Osamu Saito, Masumi Takada, Yuka Uratani, and Yuri Miyazaki for their valuable contributions in conducting this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded by the Japan Society for the Promotion of Science (JSPS), KAKENHI (Grant Number 23K16582).