Turkish archives of otorhinolaryngology · 2025
Vestibulo-ocular Reflex Gain Asymmetry in Unilateral Ménière's Disease: Insights from HIMP and SHIMP Tests and Correlations with Audio-vestibular Findings.
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Yüksel Aslıer Nesibe Gül, Ekim Buse
Аннотация
OBJECTIVE: The purpose of this study was to calculate the vestibulo-ocular reflex (VOR) gain asymmetry ratios obtained from head impulse paradigm (HIMP) and suppression HIMP (SHIMP) tests in patients with unilateral definite Ménière's disease (MD) and to investigate their relationships with clinical, audiologic and vestibular parameters.
METHODS: The study included 35 (18 female, 17 male) unilateral MD patients with a median age of 50 (24-65). All patients underwent pure-tone audiometry, video-nystagmography, including caloric test, and video head impulse test. The VOR gain asymmetry indices were computed and the demographic, clinical and audio-vestibular variables were analyzed.
RESULTS: Mean HIMP lateral canal VOR gain asymmetry ratio was -11.27±25.276 and mean SHIMP lateral canal VOR gain asymmetry was -15.63±23.993. While differences in caloric response asymmetry ratios were observed among hearing-loss severity groups (p=0.05), HIMP and SHIMP asymmetry ratios did not differ. VOR gain asymmetry ratios showed significant differences among dizziness handicap inventory groups, SHIMP saccade group and visually enhanced VOR saccade group (p<0.05). Significant correlations were found between SHIMP and caloric asymmetry ratios with air-conduction pure-tone averages (r=-0.337, p=0.047 and r=-0.358, p=0.035), and between HIMP lateral canal asymmetry and hearing at 500 Hz (r=-0.362, p=0.032).
CONCLUSION: Our study confirmed that VOR gain asymmetry assessed by SHIMP and HIMP differs across hearing levels; and further that caloric response asymmetry is also correlated with audio-vestibular parameters in patients with unilateral MD.
METHODS: The study included 35 (18 female, 17 male) unilateral MD patients with a median age of 50 (24-65). All patients underwent pure-tone audiometry, video-nystagmography, including caloric test, and video head impulse test. The VOR gain asymmetry indices were computed and the demographic, clinical and audio-vestibular variables were analyzed.
RESULTS: Mean HIMP lateral canal VOR gain asymmetry ratio was -11.27±25.276 and mean SHIMP lateral canal VOR gain asymmetry was -15.63±23.993. While differences in caloric response asymmetry ratios were observed among hearing-loss severity groups (p=0.05), HIMP and SHIMP asymmetry ratios did not differ. VOR gain asymmetry ratios showed significant differences among dizziness handicap inventory groups, SHIMP saccade group and visually enhanced VOR saccade group (p<0.05). Significant correlations were found between SHIMP and caloric asymmetry ratios with air-conduction pure-tone averages (r=-0.337, p=0.047 and r=-0.358, p=0.035), and between HIMP lateral canal asymmetry and hearing at 500 Hz (r=-0.362, p=0.032).
CONCLUSION: Our study confirmed that VOR gain asymmetry assessed by SHIMP and HIMP differs across hearing levels; and further that caloric response asymmetry is also correlated with audio-vestibular parameters in patients with unilateral MD.