Sensitivity of caloric test versus video head impulse test for detection of vestibulo-ocular reflex abnormalities in Meniere's disease

Purpose: This study aimed to evaluate vestibulo-ocular reflex (VOR) in subjects with Meniere’s disease using caloric test and video head impulse test (vHIT). Patients and Methods: A case control study included 120 subjects: 60 normal subjects (control group) and 60 subjects diagnosed as Meniere’s disease (MD) according to (AAO-HNS) 2015 criteria with hearing loss (study group). All subjects enrolled in this study underwent: Detailed clinical history, audiological and vestibular evaluation. vHIT and bithermal caloric test were done to evaluate the vestibulo-ocular reflex. Results: The entire control group had normal vHIT, and VNG (bithermal caloric test) results. In the MD group: vHIT reveals (37%) abnormality: (28% for low gain & 8% for saccades). But in bithermal caloric test; unilateral canal paresis was detected in (40%), and bilateral canal paresis in (15%). Thirty three percent had abnormality in both caloric and vHIT. Conclusion: Caloric test is more sensitive in detection of VOR abnormalities in Meniere’s disease. Results of caloric test and, vHIT show discrepancy but complementary to each other. Adding vHIT to the VNG is recommended for diagnosis of vestibular disorders.