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Summary of November 2018 Topic: vHIT

The first article was a review of the literature regarding the video head impulse test (vHIT). The review included 27 articles. One finding is that the video HIT is more sensitive than the clinical head impulse test (cHIT). If the vHIT is negative, caloric testing should be performed to rule out a hypofunction. All canals should be tested in an attempt to isolate the weakness.

The next study aimed to compare the results of vHIT and caloric testing in adolescents. 49 subjects were included in the prospective study, average age was 16. All participants underwent bi-thermal caloric testing with air and vHIT on the same day. Calorics were normal in all cases. 84% had abnormal vHIT and approximately 1/3 of these had multiple canal involvement, of these all had the same ear affected. Posterior canal was most commonly affected. vHIT is a good test for adolescents and children and provides useful information.

The main objective of the next study was to assess if a relationship exists between vHIT and self-reported dizziness. Secondary goal included comparing the vHIT to caloric testing. 115 participants filled out the Dizziness Handicap Inventory (DHI) and had caloric and vHIT testing on the same day. It was determined that the DHI could not be used to predict outcomes of vHIT. The study also showed that vHIT and caloric testing are not redundant but instead complimentary, providing different functional integrity information of the horizontal canal. The vHIT lacks some sensitivity compared to calorics but is easier for the patient to tolerate and takes less time to complete.

 

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