Correlation between nystagmus intensity and vestibular–ocular reflex gain in benign paroxysmal positional vertigo: A prospective, clinical study

Article type: Research Article

Authors: Onal, Merih^{a; *} | Aygun, Ahmet^b | Colpan, Bahar^{a; 1} | Karakayaoglu, Harun^{a; 2} | Onal, Ozkan^{c; d; 3}

Affiliations: [a] Selcuk University Faculty of Medicine, Department of Otorhinolaryngology, Konya, Turkey | [b] Selcuk University Faculty of Medicine, Department of Otorhinolaryngology, Subdepartment of Audiometry, Konya, Turkey | [c] Cleveland Clinic Main Hospital, Anesthesiology Institute, Outcomes Research Consortium, Cleveland, Ohio, USA | [d] Selcuk University Faculty of Medicine, Department of Anesthesiology and Reanimation, Konya, Turkey

Correspondence: [*] Corresponding author: Merih Onal, Department of Otorhinolaryngology, Selcuk University Faculty of Medicine, Yeni Istanbul Street, Alaaddin Keykubat Campus, Selcuklu, Konya, 42100, Turkey. Tel.: +90 555 4376238; E-mail: [email protected]; https://orcid.org/0000-0003-0591-8411

Note: [1] Bahar Colpan Keles: https://orcid.org/0000-0001-7642-9303

Note: [2] Harun Karakayaoglu: https://orcid.org/0000-0002-9855-3169

Note: [3] Ozkan Onal: https://orcid.org/0000-0002-5574-1901

Abstract: BACKGROUND:Video head impulse test (vHIT) and videonystagmography (VNG) provide significant benefits in evaluating benign paroxysmal positional vertigo (BPPV) and determining the semicircular canal localization of the otoconia. OBJECTIVE:This study aimed to investigate the relationship between vestibular–ocular reflex (VOR) gains measured via vHIT and the slow-phase velocity (SPV) of nystagmus in patients with the posterior semicircular canal (PSCC)-BPPV. METHODS:Sixty-two patients were included in this study and divided into the study (n = 32, patients with isolated PSCC-BPPV) and control (n = 30, age- and sex-matched healthy individuals) groups. While VOR gains were measured with vHIT in both groups and compared between groups, the SPV values of nystagmus observed during the Dix-Hallpike maneuver in the study group were recorded using VNG and compared with the VOR gains of the study group. RESULTS:There were significant differences in posterior canal VOR gains between the study and control groups (p < 0.001 and p < 0.01, respectively). Although the affected PSCC had decreased VOR gains versus the control group, it was still within the normal range. However, there was no significant relationship between the VOR gains of the affected PSCC and the SPV of the nystagmus. CONCLUSIONS:vHIT can help detect semicircular canal dysfunction in patients with PSCC-BPPV. The SPV values of nystagmus on VNG during the Dix–Hallpike maneuver do not correlate with the level of VOR gain.

Keywords: Benign paroxysmal positional vertigo, vestibular function tests, head impulse test, vestibulo–ocular reflex, semicircular canals

DOI: 10.3233/VES-220106

Journal: Journal of Vestibular Research, vol. 33, no. 2, pp. 115-125, 2023