Interpretation and use of caloric testing.
Caloric testing is an otoneurologic evaluation of the status of the vestibular-ocular reflex; it allows an evaluation of each labyrinth separately. The main aspects on the use and interpretation of caloric testing are reviewed.


METHODS
A systematic review of papers published in the past one hundred years on caloric testing was undertaken. The inclusion criteria were: cross-sectional, longitudinal, original articles, reviews and meta-analyses. Reviews of patient charts, case reports and editorials were excluded. The key-words were: caloric testing, nystagmus, vestibular system, directional preponderance, labyrinth predominance, monothermal caloric test, ice water caloric testing, Bell s phenomenon. The databases were: COCHRAINE, MEDLINE, LILACS, CAPES.


RESULTS
Ninety-three of 818 abstracts fulfilled the inclusion criteria. After reading these articles, 55 were selected for this study. These papers discussed the basics of caloric testing, the types of stimulation, the interpretation of results, variables, artifacts, and the monothermal and ice water caloric test.
Caloric testing reference values may vary according to each unit; the the cutoff point is defined based on local studies. Attention to the technique is essential to maximize test sensitivity.
Gonçalves
Denise Utsch
DU
Departament of Ophthalmology, Otolaryngology and Speech and Hearing Therapy, University of Minas Gerais Medical School, Brazil. deniseg@medicina.ufmg.br
Felipe
Lilian
L
Lima
Tânia Mara Assis
TM
D002150:Caloric Tests / Q000379:methods*; D006801:Humans; D009760:Nystagmus, Physiologic; D012027:Reflex, Vestibulo-Ocular / Q000502:physiology*; D015837:Vestibular Diseases / Q000175:diagnosis* / Q000503:physiopathology*