title: Video head impulse testing (VHIT) in the pediatric population.
abstract: OBJECTIVE
  VHIT is the first vestibular test to evaluate all six semicircular canals. This test has advantages over the rotary chair and caloric tests in evaluating children since it does not require fear-inducing darkness or provocation of dizziness. The goal of this study was to review our initial experience with VHIT in children and adolescents at a pediatric vestibular program.
  
  
  METHODS
  Results using the ICS Impulse VHIT device in 33 patients <20 years of age were retrospectively reviewed. Rotary chair testing was used to designate 26 subjects into groups with normal (n=20) and abnormal (n=6) lateral semicircular canal (LSC) function for comparison.
  
  
  RESULTS
  Ages ranged from 3 to 19 years (mean 13±4.3) with no statistically significant difference in mean lateral canal gains between age groups (3-10, 11-14, 15-19 years, respectively) by one-way ANOVA, p=0.111. LSC VHIT gain of <0.7 demonstrated sensitivity of 66.7%, specificity of 100%, positive predictive value of 100%, negative predictive value of 90.9% for detecting abnormal LSC function. Corrective saccades demonstrated 100% sensitivity and 100% specificity for detecting abnormal LSC function. VHIT gain <0.7 in an anterior (n=7) or posterior (n=9) canal was only found in subjects with a clinical history and abnormal findings on other tests indicative of a diagnosis involving the affected canal (e.g. benign paroxysmal positioning vertigo, vestibular neuritis, etc.).
  
  
  CONCLUSIONS
  VHIT is an effective test for evaluating semicircular canal function in children and offers major potential advantages over rotary chair and caloric testing.
authors.affiliation: The Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; The Department of Otology and Laryngology, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA. Electronic address: steven.hamilton@childrens.harvard.edu.
authors.forename: Steven S
authors.initials: SS
authors.lastname: Hamilton
authors.affiliation: The Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; The Department of Otology and Laryngology, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA. Electronic address: guangwei.zhou@childrens.harvard.edu.
authors.forename: Guangwei
authors.initials: G
authors.lastname: Zhou
authors.affiliation: The Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; The Department of Otology and Laryngology, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA. Electronic address: jacob.brodsky@childrens.harvard.edu.
authors.forename: Jacob R
authors.initials: JR
authors.lastname: Brodsky
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D064087:Head Impulse Test / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012027:Reflex, Vestibulo-Ocular; D012189:Retrospective Studies; D012665:Semicircular Canals / Q000503:physiopathology*; D014717:Vertigo / Q000175:diagnosis / Q000503:physiopathology; D020338:Vestibular Neuronitis / Q000175:diagnosis / Q000503:physiopathology; D055815:Young Adult
keywords: Children; Pediatric vertigo; VHIT; Vestibular testing; Video head impulse test