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Suppression head impulse testing is recommended for vestibular testing of patients with untreated unilateral vestibular schwannoma

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Suppression head impulse testing (SHIMP) is a new vestibular method capable of quantifying vestibular function. The aim of this study was to evaluate the feasibility of this test in patients with existing or newly diagnosed vestibular schwannoma (VS) patients by comparing the results with the traditionally used video head impulse test (vHIT or HIMP).

Methods

Fifty-five patients with unilateral VS underwent a wide battery of audiological and vestibular tests. HIMP results were evaluated using newly introduced objective guidelines based on the trace evaluation of pathological saccades. The sensitivity and specificity of HIMP and SHIMP were evaluated and compared. A new SHIMP parameter is presented; the anticompensatory saccade amplitude ratio (ASAR).

Results

We found a marked increase in specificity in HIMP testing using the objective guidelines. SHIMP testing revealed a gain threshold of 0.7 to be optimal in terms of achieving high specificity and sensitivity in relation to HIMP testing. Significant correlations were found between a low ASAR and a high degree of vestibular pathology.

Conclusion

The SHIMP test is a viable addition to the standard HIMP test in patients with VS, especially with the addition of the ASAR, which could prove useful in monitoring the residual vestibular function.

Trial registration number and date of registration

N/A.

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Data availability

All data are 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.

Code availability

All codes used are commercially available.

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Authors and Affiliations

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

    Morten Klitskov Jensen & Dan Dupont Hougaard

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

    Morten Klitskov Jensen & Dan Dupont Hougaard

  3. Audiological Department, Balance and Dizziness Centre, Havrevangen 1, 9000, Aalborg, Denmark

    Morten Klitskov Jensen

Authors
  1. Morten Klitskov Jensen
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Contributions

All authors made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work. Drafted the work or revised it critically for important intellectual content. Approved the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Morten Klitskov Jensen.

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Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

N/A. Complete video Head Impulse Testing with both HIMP and SHIMP test protocols and fulfillment of the Dizziness Handicap Questionnaire is part of the standard clinical evaluation of patients diagnosed with a vestibular schwannoma and the equipment used in this study is 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 both types of vHIT testing prior to testing.

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Jensen, M.K., Hougaard, D.D. Suppression head impulse testing is recommended for vestibular testing of patients with untreated unilateral vestibular schwannoma. Eur Arch Otorhinolaryngol 279, 91–99 (2022). https://doi.org/10.1007/s00405-021-06621-y

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  • DOI: https://doi.org/10.1007/s00405-021-06621-y

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