Evaluation of Suppression Head Impulse Paradigm (SHIMP) and the Video Head Impulse Test (vHIT) in Patients with Meniere’s disease with Proven Vestibular and Auditory Loss

Abstract

This study aimed to examine the results of the video head impulse test (vHIT), and suppression head impulse paradigm (SHIMP) in adult diagnosed with definite Meniere’s disease (MD). This study was conducted with 20 patients aged 18-45 years with canal paresis and sensorineural type hearing loss in symptomatic ears, who were diagnosed with unilateral definite MD. The subjects were assessed with conventional audiometry (0.125–8 kHz), the bithermal binaural air caloric test, vHIT, and SHIMP. The mean SHIMP vestibulo-ocular reflex (S-VOR) gain of the MD side was 0.69, and that of the healthy side was 0.77. The S-VOR gain values were statistically lower than the mean vHIT VOR gain (V-VOR) values on both sides (p<0.001). There was no significant difference between the MD and healthy sides in terms of the anti-compensatory saccades (ACSs) latency and amplitude and S-VOR gain (p>0.05). In the MD group, the vHIT results were abnormal in 35% (7/20 ears) of the ears, and the SHIMP results were abnormal in 50% (10/20 ears). On the healthy side, the vHIT results were abnormal in 10% (2/20 ears) of the ears, and the SHIMP results were abnormal in 35% (7/20 ears). In this study, the V-VOR and S-VOR gains, vHIT saccades, SHIMP saccade latency, and SHIMP saccade amplitude were not found to be beneficial parameters in differentiating affected and healthy ears in the patients with MD. In other words, contrary to expectations, vHIT and SHIMP tests were not sufficient to detect pathological involvement in Meniere's disease.