Video Head Impulse Test in Patients with Unilateral Meniere's Disease:A Series of 67 Cases

SHI Xiaoling; GONG Jiamin; FAN Ting; ZHOU Ruoqiao; YIN Yanbo; WANG Yunfeng

doi:10.3969/j.issn.1672-2922.2024.06.002

Abstract：Objective To report Video Head Impulse Test(vHIT)results in patients with Meniere's Disease(MD)and to assess their potential relationship to MD staging.Methods Data from 67 patients with unilateral MD treated at the Department of Otolaryngology,Fudan EENT Hospital,from January 2021 to December 2022 were retrospective analyzed.Cases were categorized as early(15 cases)or late stage(52 cases)based on hearing loss(>40 dB).vHIT gain and the frequency of overt and covert saccades were compared.Results Among the 67 patients,Involvement of the ipsilateral semicircular canals was implicated in 29 cases,including the anterior semicircular canal(ASC)in 1 case,the horizontal semicircular canal(HSC)in 29 cases,and the posterior semicircular canal(PSC)in 11 cases.Abnormalities of contralateral semicircular canals were implicated in 13 cases,involving the ASC in 1 case,HSC in 11 cases,and PSC in 4 cases.Involvement of ipsilateral semicircular canals was more common than that of contralateral canals(P<0.001).vHIT gain on the affected side was lower than that on the healthy side for the HSC(P<0.05),with higher of overt saccadic frequencies,but not for the ASC and PSC(P>0.05).The rate of positive MRI findings was not significantly different between patients with early and those with late stage MD(P>0.05),as with the rates of vHIT abnormality for the ASC and PSC(P>0.05).However,the rate of overt saccades for the HSC was significantly higher in patients with late stage MD compared to those with early stage MD(P<0.05),despite no significant differences in vHIT gain or covert saccades(P>0.05).Conclusion In patients with MD,abnormalities are more frequently observed in the HSC and PSC,and rarely in the ASC.The presence of overt saccades for the HSC,as measured by vHIT,is associated with MD stage,suggesting that vHIT may serve as an effective diagnostic tool for predicting the stage of MD.