The Dissociation of Video Head Impulse Test (vHIT) and Bithermal Caloric Test Results Provide Topological Localization of Vestibular System Impairment in Patients With “Definite” Ménière's Disease

Abstract

Purpose We report 3 patients with Ménière's disease and describe how the combination of audiometry, video head impulse testing, and caloric results may prove helpful in the diagnosis of Ménière's disease. Method Three patients with “definite” Ménière's disease were evaluated in a tertiary care medical center. Each patient underwent videonystagmography, horizontal canal video head impulse testing, and audiometry. Results All 3 patients demonstrated moderate, flat, sensorineural hearing losses; significant caloric asymmetries; and bilaterally normal video head impulse testing. This pattern of findings suggests differential preservation of high-frequency function (video head impulse testing) with impairment of low-frequency function (unilaterally abnormal caloric test results) in these patients. Conclusion Ipsilesional abnormal caloric testing in the presence of normal video head impulse testing is a pattern of findings observed in a cohort of patients who have “definite” Ménière's disease.