Comparison of Video Head Impulse Test and Caloric Reflex Test in advanced unilateral definite Meniere's disease

Aims: There have been very few studies of the Video Head Impulse Test (VHIT) in patients with Meniere's Disease (MD). Some reported 100% normal VHIT results, others not. These discrepancies may be due to differences in severity. The present study compared VHIT and caloric reflex test results in advanced unilateral definite MD. Material and method: A prospective study included 37 consecutive patients, with a mean age of 56 + 12 years. Mean hearing loss was 59 +/- 18 dB HL; 12 patients were subject to Tumarkin's otolithic crises. Abnormal caloric reflex was defined as >20% deficit, and abnormal VHIT as presence of saccades or <0.64 gain in vertical semicircular canals and <0.78 in horizontal canals. Results: All patients had normal VHIT results, and 3 had normal caloric reflex; mean caloric reflex deficit was 45%. Conclusion: The present study is the only one to use the August 2015 updated definition of MD. The results showed that, outside of episodes of crisis, VHIT was normal during advanced unilateral definite MD, in contrast to abnormal caloric reflex. This feature could help distinguish MD from other inner ear diseases, and it would be interesting to try to confirm this hypothesis by studying MD patients. (C) 2017 Elsevier Masson SAS. All rights reserved.