Comparison of test results from two separate video head impulse test systems in a cohort of patients diagnosed with a unilateral vestibular schwannoma

Eur Arch Otorhinolaryngol. 2020 Nov;277(11):3185-3193. doi: 10.1007/s00405-020-06116-2. Epub 2020 Jun 20.

Abstract

Purpose: Video head impulse testing (vHIT) is a relatively new technology enabling evaluation of vestibular function. The aim of this study was to compare the test results from two separate vHIT systems in a group of patients diagnosed with a unilateral vestibular schwannoma (VS) with regards to sensitivity, specificity and inter-examiner differences.

Methods: Forty-two patients were examined with two separate vHIT systems: EyeSeeCam® (system A) and ICS Impulse® (system B), by one of two examiners. All six semicircular canals (SCCs) were tested under standardized conditions, and strict criteria were set up for post-test interpretation.

Results: With the majority of test parameters, the two test systems were in agreement. Vestibular deficits were found in 40.5% (system A) to 45% (system B) of patients with a VS on the tested side; corresponding to a positive predictive value (PPV) of 86.4% (system B) to 94.4% (system A). The specificity was 97.6% for system A and 92.9% for system B. An overall agreement between the two vHIT systems measured as kappa was computed to be 0.61. There were no significant inter-examiner differences. When testing the vertical SCCs, a tendency of too high mean gain values was seen with system A but not with system B.

Conclusion: In patients with unilateral VS, vHIT is a test with moderate sensitivity and high specificity in regard to identification of a vestibular deficit. There were no significant differences in test results between the two vHIT systems.

Keywords: Sensitivity; Test agreement; Vestibular function; Vestibular schwannoma; Video head impulse test; vHIT.

MeSH terms

  • Head Impulse Test
  • Humans
  • Neuroma, Acoustic* / diagnosis
  • Reflex, Vestibulo-Ocular
  • Semicircular Canals
  • Vestibule, Labyrinth*