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Comparison of test results from two separate video head impulse test systems in a cohort of patients diagnosed with a unilateral vestibular schwannoma

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Abstract

Purpose

Video head impulse testing (vHIT) is a relatively new technology enabling evaluation of vestibular function. The aim of this study was to compare the test results from two separate vHIT systems in a group of patients diagnosed with a unilateral vestibular schwannoma (VS) with regards to sensitivity, specificity and inter-examiner differences.

Methods

Forty-two patients were examined with two separate vHIT systems: EyeSeeCam® (system A) and ICS Impulse® (system B), by one of two examiners. All six semicircular canals (SCCs) were tested under standardized conditions, and strict criteria were set up for post-test interpretation.

Results

With the majority of test parameters, the two test systems were in agreement. Vestibular deficits were found in 40.5% (system A) to 45% (system B) of patients with a VS on the tested side; corresponding to a positive predictive value (PPV) of 86.4% (system B) to 94.4% (system A). The specificity was 97.6% for system A and 92.9% for system B. An overall agreement between the two vHIT systems measured as kappa was computed to be 0.61. There were no significant inter-examiner differences. When testing the vertical SCCs, a tendency of too high mean gain values was seen with system A but not with system B.

Conclusion

In patients with unilateral VS, vHIT is a test with moderate sensitivity and high specificity in regard to identification of a vestibular deficit. There were no significant differences in test results between the two vHIT systems.

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Data availability

All data were stored and registered in the electronic data capture systems provided by the manufacturers and stored in the Regional Electronic Data Record Systems provided by the University Hospital.

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Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark

    Mathilde Aalling, Emil Riis Abrahamsen & Dan Dupont Hougaard

  2. Unit of Clinical Biostatistics and Bioinformatics, Aalborg University Hospital, Aalborg, Denmark

    Regitze Kuhr Skals

  3. Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

    Dan Dupont Hougaard

Authors
  1. Mathilde Aalling
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  2. Regitze Kuhr Skals
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  3. Emil Riis Abrahamsen
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  4. Dan Dupont Hougaard
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Corresponding author

Correspondence to Mathilde Aalling.

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Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

Complete vHIT testing and fulfillment of the Dizziness Handicap Questionnaire is part the standard clinical evaluation of patients diagnosed with a vestibular schwannoma and both types of vHIT equipment used in this study are already approved for clinical testing. Furthermore, no patients had to undergo randomization to additional treatments or examinations. Therefore, a formal application to the North Denmark Region Committee on Research Ethics was not deemed necessary.

Consent to participate

All subjects were thoroughly informed about the vHIT testing prior to the test.

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Aalling, M., Skals, R.K., Abrahamsen, E.R. et al. Comparison of test results from two separate video head impulse test systems in a cohort of patients diagnosed with a unilateral vestibular schwannoma. Eur Arch Otorhinolaryngol 277, 3185–3193 (2020). https://doi.org/10.1007/s00405-020-06116-2

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