A head autorotation test for patients with Menière's disease.
OBJECTIVE
We compared the vestibulo-ocular reflex (VOR) of healthy volunteers and of two groups (group A, conservatively treated; and group B, with gentamicin or surgically treated) of Menière's disease (MD) patients to determine whether the head autorotation test (HART) can reveal abnormality of the VOR and whether the HART can be applied in evaluation of MD.


METHODS
The gain, phase, asymmetry, and the highest frequency band reached was evaluated with the HART in the frequency range of 1-5 Hz. The caloric responses and posturography results were also determined.


RESULTS
The mean gain was lower for the both groups of MD patients than for the controls. In the MD patients the phase difference was shorter and the asymmetry was greater than in the controls. Only 58% (group A) and 36% (group B) of the MD patients reached the frequency band of 4 Hz, and 33% (group A) and 19% (group B) reached 5 Hz. The respective percentages for the controls were 97 and 77%. Of the 25 MD patients (group B) 72% had abnormal HART results. Among the group A of MD patients the HART (50%) was more sensitive to VOR abnormality than the caloric test (10%) was. For aggressively treated MD patients a decrease in gain at 2 and 3 Hz in the HART correlated with abnormal caloric test results. Increased body sway in posturography correlated with the pathological results in the HART.


CONCLUSIONS
The HART is a complementary method for evaluating the natural frequency range of the VOR, and evaluation of MD patients may benefit from combined results of the caloric test and HART.
Department of Otorhinolaryngology, University Central Hospital of Helsinki, Finland. timo.hirvonen@helsinki.fi
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Hirvonen
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Pyykkö
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Aalto
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002150:Caloric Tests; D003131:Combined Modality Therapy; D007758:Ear, Inner / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage; D019416:Head Movements / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D008875:Middle Aged; D012016:Reference Values; D012027:Reflex, Vestibulo-Ocular / Q000187:drug effects / Q000502:physiology*; D012680:Sensitivity and Specificity; D014724:Vestibular Function Tests; D014725:Vestibular Nerve / Q000503:physiopathology / Q000601:surgery
D005839:Gentamicins