Otology & Neurotology最新文献

{"title":"Ménière's Disease With a Prior Diagnosis of Idiopathic Sudden Hearing Loss.","authors":"Minerva Rodriguez-Martín, Rocío González-Aguado, Trinidad Dierssen Sotos, Carmelo Morales-Angulo","doi":"10.1097/MAO.0000000000004508","DOIUrl":"10.1097/MAO.0000000000004508","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to determine the percentage of patients with idiopathic sudden hearing loss later diagnosed with Ménière's disease. It also seeks to identify predictive factors for Ménière's diagnosis and compare treatment responses between first-time Ménière's patients and those with idiopathic sudden hearing loss.</p><p><strong>Study design: </strong>A prospective observational study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Cohort of apparently idiopathic sudden hearing loss patients over a period of 30 years (1992-2022).</p><p><strong>Intervention: </strong>Identification of Ménière's disease cases during follow-up.</p><p><strong>Main outcome measure: </strong>Determining how many were subsequently diagnosed with definitive Ménière's disease.</p><p><strong>Results: </strong>From a cohort of 369 patients with apparently idiopathic sudden hearing loss treated over 30 years, 15 (4%) developed definite Ménière's disease.The predictive factors for developing Ménière's disease were mild to moderate hearing loss, vertigo, tinnitus at the initial episode, and a predominantly ascending audiometric curve.When comparing treatment responses, patients with Ménière's disease showed better outcomes than those with idiopathic sudden hearing loss.</p><p><strong>Conclusions: </strong>Cases of sudden sensorineural hearing loss that represent the first episode of definite Ménière's disease are rare. A moderate hearing loss at low frequencies, accompanied by tinnitus and vertigo during an episode of sudden hearing loss, should raise suspicion for Ménière's disease rather than idiopathic sudden hearing loss. Patients with sudden hearing loss secondary to an episode of Ménière's disease tend to show significantly greater hearing improvement compared with those with idiopathic sudden hearing loss.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"680-685"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-Assessing the Interpretation of Beta Trace Protein Levels in Middle Ear Fluid in the Assessment for Lateral Skull Base Cerebrospinal Fluid Leaks.","authors":"Katherine Pollaers, John Joseph, Ee Mun Lim, Jafri Kuthubutheen, Stephen Rodrigues","doi":"10.1097/MAO.0000000000004475","DOIUrl":"10.1097/MAO.0000000000004475","url":null,"abstract":"<p><strong>Hypothesis: </strong>Describe the range of values of BTP obtained in middle ear fluid samples and determine if the level of BTP is a reliable indicator of the presence of a cerebrospinal fluid middle ear effusion.</p><p><strong>Background: </strong>Beta trace protein is a glycoprotein abundant in the CSF. Middle ear fluid samples are tested for the presence of BTP, which provides a numerical representation of the concentration of CSF. A middle ear fluid sample deemed to be positive for CSF has a BTP level of greater than 1.3 mg/L. However, this level is not specific to the middle ear, and there is a paucity of literature regarding interpretation of the BTP level when used in the evaluation for suspected lateral temporal bone CSF leaks.</p><p><strong>Methods: </strong>Retrospective review of all middle and nasal fluid samples sent by otolaryngologists for beta trace protein testing in Western Australia over a 4-year period.</p><p><strong>Results: </strong>A total of 168 patients had a middle ear fluid sample sent for BTP testing; these samples were obtained via tympanocentesis through an intact tympanic membrane with no other ear or temporal bone pathology. Ninety-six (96%) of the middle ear samples (172 of 178) had a BTP level greater than 1.3 mg/L, indicating a positive result and suggesting the presence of cerebrospinal fluid within the sample.</p><p><strong>Conclusion: </strong>The BTP level of middle ear fluid aspirates should be viewed with caution and used in conjunction with radiological findings and clinical impressions in the formulation of a management plan in patients suspected of lateral skull base CSF leaks.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"700-705"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Evidence on the Influence of Implant Position onto Maximum Output with the Bonebridge Bone Conduction Implant.","authors":"Daniel Schurzig, Rebecca Iseke, Hannes Maier, Nils Kristian Prenzler, Thomas Lenarz, Mohammad Ghoncheh","doi":"10.1097/MAO.0000000000004533","DOIUrl":"10.1097/MAO.0000000000004533","url":null,"abstract":"<p><strong>Hypothesis: </strong>In bone conduction implantation, the position of the implant influences the audiological benefit of the patient.</p><p><strong>Background: </strong>One way of treating hearing loss is the implantation of bone conduction implants (BCIs), which effectively transmit vibrations through the skull bone to the cochlea given that the implant transducer is securely fixated. Laboratory research on the efficacy of bone conduction sound transmission found that a closer proximity of the transducer to the ipsilateral cochlea yields significantly higher cochlear promontory vibrations and hence, higher stimulation efficacy. Up to now, this finding has not been reproduced using clinical data such as the functional or effective gain.</p><p><strong>Methods: </strong>The present, retrospective study was conducted on a cohort of 28 BCI patients to correlate the implantation site of the BC transducer, derived from clinical postoperative imaging and defined in a standardized coordinate system, with maximum output values that are exclusively based on a novel calculation method only employing clinical audiological data.</p><p><strong>Results: </strong>It could be shown that the efficacy of BCI stimulation is in fact correlated with the transducer distance to the cochlea, and that this correlation is frequency dependent. Furthermore, the longitudinal distance of the transducer and the ipsilateral external auditory canal is negatively correlated with the maximal output while the sagittal distance is not.</p><p><strong>Conclusion: </strong>The present study is hence the first one to clinically demonstrate the significance of BCI placement for maximizing patient benefit, which should be considered during the preoperative planning of bone conduction implantation.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"725-732"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Diagnostic Accuracy of the Side-Lying Test for Posterior Canal BPPV: Sensitivity and Specificity Analysis.","authors":"Neetu Rani Dhiman, Dharma Raj, Vyom Gyanpuri, Anand Kumar, Varun Kumar Singh, Abhishek Pathak, Rameshwar Nath Chaurasia, Vijay Nath Mishra, Deepika Joshi","doi":"10.1097/MAO.0000000000004505","DOIUrl":"10.1097/MAO.0000000000004505","url":null,"abstract":"<p><strong>Background objective: </strong>The side-lying (SL) test is a diagnostic maneuver used to identify posterior canal benign paroxysmal positional vertigo (PC-BPPV). It is often used as an alternative to the Dix-Hallpike (DH) test, particularly for patients who have mobility limitations. The objective of this study is to evaluate the sensitivity and specificity of the SL test in diagnosing PC-BPPV compared with the DH test.</p><p><strong>Methods: </strong>A cohort of 320 patients presenting with symptoms of vertigo underwent both the SL test and the DL maneuver. Two groups-group A and group B-were randomly formed. Group A patients were assessed with first DL test, then SL test and group B patients were assessed with first SL then DH. The diagnostic accuracy of the SL test was assessed by determining its sensitivity and specificity in relation to the DH test, which served as the reference standard.</p><p><strong>Results: </strong>The SL test demonstrated 95.1% sensitivity and 96.97% specificity in detecting posterior canal BPPV, with comparable diagnostic accuracy to the DH test. Chi-square test (140.34) also emphasized the statistical significance of these results. The DH test's AUC of 0.902 shows a high capacity to differentiate between cases with and without BPPV. On the other hand, the SL test shows even greater performance in distinguishing between BPPV and non-BPPV cases, as seen by its higher AUC of 0.960.</p><p><strong>Conclusion: </strong>The SL test is a viable alternative to the DH test, offering similar sensitivity and specificity in diagnosing posterior canal BPPV. Its use may benefit patients with physical limitations.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"675-679"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Large-Scale Video Head Impulse Test Data: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.","authors":"Jessie N Patterson, Meredith E Adams, Manuel Vicente, Pamela J Schreiner, Kristen L Janky","doi":"10.1097/MAO.0000000000004510","DOIUrl":"10.1097/MAO.0000000000004510","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the quality and agreement of video head impulse test (vHIT) data collected by technicians without extensive vestibular training compared with audiologists.</p><p><strong>Study design: </strong>Review of data collected at a single time point (year 35) as part of a larger observational cohort study known as the Coronary Artery Risk Development in Young Adults (CARDIA) study.</p><p><strong>Setting: </strong>Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA.</p><p><strong>Participants: </strong>464 participants (928 ears) enrolled in the CARDIA Study, 5 novice technicians who completed vHIT, and 3 audiologists with extensive vHIT training.</p><p><strong>Intervention: </strong>Each technician completed a 2-hour, virtual vHIT training. Technicians recorded average head velocity, gain, presence/absence of saccades, and a data quality rating. Three audiologists with extensive vestibular experience re-reviewed all data for comparison. Data categorized as noisy and/or having saccades were reanalyzed to determine whether data cleaning improved interpretation.</p><p><strong>Main outcomes measures: </strong>vHIT gain, quality of vHIT results, presence of saccades.</p><p><strong>Results: </strong>A total of 823 ears (88.7%) were classified as normal, 10 ears (1.1%) were abnormal, 13 ears (1.4%) had low gain without saccades, and 82 ears (9%) had high gain (>1.2). The most frequent artifact was high gain. Data cleaning increased the percentage of saccades and changed the interpretation of eight participants (1.7%).</p><p><strong>Conclusions: </strong>Novice examiners can administer vHIT with online training and an initial practice period. Additional training on how to identify artifacts and clean data can improve population-based vHIT testing.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"686-692"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensitivity and Specificity of Intraoperative TransImpedance Matrix Recordings Compared With X-ray Imaging in Detecting Perimodiolar Cochlear Implant Tip Foldovers: A Multicenter Study.","authors":"Alexandra M Arambula, Robin Piper, Gail Murray, Sarah E Mowry, Alejandro Rivas, Maroun Semaan, Nauman F Manzoor, Daniel E Killeen, David C Kelsall, J Eric Lupo, Allison Biever, Katrina R Stidham, Regina Albinus, Samantha Morgan, Brian J Kaplan, Regina Presley, Sarah Menendez, Viral D Tejani","doi":"10.1097/MAO.0000000000004502","DOIUrl":"10.1097/MAO.0000000000004502","url":null,"abstract":"<p><strong>Objective: </strong>Characterize the sensitivity and specificity of TransImpedance Matrix (TIM) recordings compared with x-rays in detecting cochlear implant tip foldovers.</p><p><strong>Study design: </strong>Retrospective.</p><p><strong>Setting: </strong>Multi-institutional, academic and private surgery centers.</p><p><strong>Patients: </strong>Patients 6 months and older undergoing cochlear implantation.</p><p><strong>Interventions: </strong>After cochlear implant array insertion, intraoperative TIM recordings and x-rays were conducted to confirm appropriate placement. If a foldover was identified, repeat insertion, followed by TIM and x-ray, was performed.</p><p><strong>Main outcome measures: </strong>Presence of tip foldovers as determined by TIM recordings and x-rays.</p><p><strong>Results: </strong>There were 13 tip foldovers out of 484 insertions, yielding a 2.7% tip foldover rate. Using x-rays as the \"gold standard,\" TIM recordings showed 100% sensitivity, 99.6% specificity, 84.6% positive predictive value (PPV), and 100% negative predicative value in detecting tip foldovers. The x-ray images for two TIM-identified tip foldovers were interpreted as normal intraoperatively (apparent false positives), but then were interpreted as foldovers when presented to the operating surgeon postoperatively in a blinded fashion. If these false positives had been reclassified as true positives, TIM specificity and PPV would both improve to 100%.</p><p><strong>Conclusions: </strong>These results provide further support regarding the utility of TIM recordings to evaluate appropriate cochlear implant electrode array position. Despite the low tip foldover rate reported across the literature and within this study, this multicenter patient group provided a large sample size to calculate the sensitivity and specificity of TIM recordings in identifying tip foldovers. Compared with the reference-standard, x-ray imaging, TIM recordings show equivalent, and in some cases superior, performance in identification of tip foldovers. Thus, use of TIM can potentially preclude the need for routine intraoperative x-rays without compromising patient care.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"627-633"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12244962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Cost-Effectiveness of Unilateral Cochlear Implants Versus Hearing Aids in Older Adults in Japan.","authors":"Norie Imagawa, Shuji Izumi, Takashi Shimazaki, Takashi Yamauchi, Shunya Ikeda, Shinichi Noto, Hiromi Kojima, Machi Suka","doi":"10.1097/MAO.0000000000004504","DOIUrl":"10.1097/MAO.0000000000004504","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the cost-effectiveness of cochlear implants in older adults with hearing impairment 65 years or older in Japan. In addition, this study aimed to establish a basis for making recommendations for cochlear implants in clinical practice for suitable patients.</p><p><strong>Design: </strong>We conducted a cost-utility analysis using the incremental cost-effectiveness ratio (ICER) to compare unilateral cochlear implants with hearing aids. The study involved participants 65 years or older with severe-to-profound hearing loss attending two cochlear implant surgery facilities in Japan. Costs were calculated from the participants' receipt data and standard clinical paths from medical care providers. Quality-adjusted life years (QALY) were assessed by patients using the Japanese version of the Health Utilities Index Mark 3 and by medical care providers using the visual analog scale (VAS). In addition, sensitivity analyses were performed by varying the utility value, discount rate, age at implantation, and costs to estimate the ICER under different scenarios.</p><p><strong>Results: </strong>Responses were received from 26 cochlear implant users and 8 hearing aid users. After applying the survival and discount rates to the utility values and costs, the ICER was $44,533, which falls within the acceptable willingness-to-pay threshold in Japan. Sensitivity analysis showed that the ICER was the most sensitive to the utility value, followed by the discount rate.</p><p><strong>Conclusions: </strong>The findings indicate that providing cochlear implants to older adults with hearing impairment is not only beneficial in terms of improved hearing performance but also economically efficient.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"634-640"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Sticky Situation: Case Series of Successful Treatment of Glue Ear With Dupilumab.","authors":"Ethan M Kallenberger, Snimarjot Kaur, Brynn E Everist, Gregory A Ator, Selina A Gierer, Andrea F D'Mello","doi":"10.1097/MAO.0000000000004501","DOIUrl":"10.1097/MAO.0000000000004501","url":null,"abstract":"<p><strong>Objective: </strong>To highlight the efficacy of dupilumab in treating chronic otitis media with effusion (glue ear).</p><p><strong>Patients: </strong>Three patients with chronic otitis media with effusion (OME) refractory to medical and surgical treatment were retrospectively identified. All patients had medical history suggestive of the presence of eosinophilic inflammation.</p><p><strong>Interventions: </strong>Each patient received a 300-mg injection of dupilumab every 4 weeks for a total of three injections.</p><p><strong>Main outcome measures: </strong>Audiometric data, patient-reported incidence of new ear infections, patient-reported symptoms.</p><p><strong>Results: </strong>All patients reported subjective improvement in ear pain, drainage, and hearing loss between 2 weeks and 6 months on dupilumab therapy. In case 1 and case 2, audiograms showed some improvement in hearing loss posttreatment. Case 2 had an unexpected interruption of treatment for 4 weeks and reported return of thick ear drainage and difficulty with hearing.</p><p><strong>Conclusions: </strong>Dupilumab may be a novel, effective, and nonsurgical treatment option for patients with chronic otitis media with effusion and underlying atopic conditions.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e210-e214"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Preoperative Patient Expectations in the Cochlear Implant Evaluation Process.","authors":"Christian M Shannon, Joshua E Fabie, Brittany N Hand, Kara C Schvartz-Leyzac, Judy R Dubno, Theodore R McRackan","doi":"10.1097/MAO.0000000000004521","DOIUrl":"10.1097/MAO.0000000000004521","url":null,"abstract":"<p><strong>Objective: </strong>To determine what factors are associated with patients' preoperative expectations of their postimplantation experience with their cochlear implant devices.</p><p><strong>Study design: </strong>A retrospective review of data from a prospectively maintained cochlear implant database was conducted.</p><p><strong>Setting: </strong>Tertiary, academic hospital.</p><p><strong>Patients: </strong>Adult patients who underwent a cochlear implant candidacy evaluation and completed the CIQOL-Expectations validated instrument were included.</p><p><strong>Results: </strong>Age was found to have a weak association with increased expectations in some domains of the CIQOL-Expectations. There were some very weak associations identified between a patient's baseline functional ability and their expectations in the corresponding domain. However, no modifiable variable included in the current analysis was found to have an association with patient expectations.</p><p><strong>Conclusion: </strong>Understanding patient expectations is a critical part of the success of medical interventions such as cochlear implantation. However, they are complex and likely multifactorial, and future studies are needed to look at other potential variables that may contribute to their formation.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"648-653"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caloric Test, and Qualitative and Quantitative vHIT Analysis in Vestibular Schwannoma.","authors":"Pasqualina Maria Picciotti, Rolando Rolesi, Giorgia Rossi, Angelo Tizio, Bruno Sergi, Jacopo Galli","doi":"10.1097/MAO.0000000000004503","DOIUrl":"10.1097/MAO.0000000000004503","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate relationships and discordant results between caloric testing and video head impulse testing (vHIT) among patients with unilateral vestibular schwannoma (VS), trying to establish if caloric testing and vHIT may provide complementary information on vestibular assessment.</p><p><strong>Study design: </strong>Retrospective case review.</p><p><strong>Setting: </strong>Tertiary care academic center.</p><p><strong>Patients: </strong>218 patients affected by unilateral VS and managed by \"wait and scan\" (WS), microsurgery (MS), or fractionated stereotactic radiotherapy (SRT). The analysis included patients' age, tumor size (KOOS stage), hearing level, facial nerve function, vestibular function, tumor control, and complications.The subjects' vestibular function was assessed evaluating the caloric response, vHIT gains for lateral canals and saccades, with and without gain abnormalities.</p><p><strong>Results: </strong>In the 167 eligible patients, the most common finding was both caloric and vHIT abnormal results (74 patients). In 40 cases, caloric test abnormal response was not associated with ipsilesional vestibular oculomotor reflex (VOR) amplitude alterations. In 53 patients, caloric tests and vHIT showed no abnormalities. In the three groups of patients, the number of compensatory saccadic eye movements after head motion was significantly higher, which were strongly correlated with caloric unilateral weakness (UW). Tumor size was significantly associated with an increase both in caloric UW and VOR asymmetry.</p><p><strong>Conclusion: </strong>Results highlight the importance of an accurate vHIT morphological analysis in the context of patients affected by VS. Indeed, given the relationship between vestibular deficit and number of compensatory saccades, our data further suggest that an increase in the generation of late compensatory saccadic events may reveal a vestibular deficit not adequately characterized by VOR gain analysis. A correct vestibular assessment must include the caloric test and the vHIT including both qualitative and quantitative analysis of the saccades in the presence of a normal VOR gain and normal symmetry.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e215-e223"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}