[The study on the clinical application of computer-assisted subjective visual vertical/horizontal line tests at different head deflection angles in the diagnosis of vestibular neuritis].

Objective

This study aimed to assess the clinical application of subjective visual vertical（SVV） and subjective visual horizontal（SVH） tests at different head deflection angles in the diagnosis of vestibular neuritis（VN）, offering insights for a more precise evaluation of otolith dysfunction.

Methods

A total of 40 patients with VN who were diagnosed at the Hearing Impairment and Vertigo Centre, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, between January and December 2024 were retrospectively analysed, and 31 healthy adults served as the control group. All participants underwent computer-assisted SVV/SVH tests at three head tilt angles: upright head position 0°（0°）, left head deflection 45°（L45°）, and right head deflection 45°（R45°）, and the deviation values were recorded and compared with those of the healthy control group for statistical analysis.

Results

①Compared with normal controls, the difference in the rate of SVV/SVH abnormalities at 0°, L45° and R45° deflection angles was statistically significant in patients with VN（P<0.05）, with the highest rate of abnormality at 0°; ②The rate of abnormalities on the affected side of SVV and SVH was significantly higher in VN patients than on the healthy side（P<0.05）; ③Statistically significant differences were found in the comparison of the absolute values of different head deflection angles of SVV between VN patients and healthy controls（P<0.05）, and in the comparison of the absolute values of SVH in upright head position 0° and L45° between VN patients and healthy controls（P<0.05）, while the difference in the comparison of the absolute values of R45° was not statistically significant（P>0.05）.

Conclusion

The SVV and SVH tests are important tests for assessing otolith dysfunction in patients with VN, with high sensitivity, and can quickly determine the side and degree of damage, of which the upright head position 0o is the most helpful for diagnosis, and is recommended as a routine examination head position, and this test can be an important method for the refined assessment of otolith dysfunction in patients with VN.