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Comparisons of Supine Roll Test and Alternative Positional Tests in HC-BPPV Lateralization

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Abstract

Objective

The purpose of the study was to evaluate the efficiency of the supine roll test (SRT) and alternative positional tests (APTs) including the bow and lean test (BLT), pseudo-spontaneous nystagmus (PSN), and lying down nystagmus (LDN) to identify the affected side in horizontal canal benign paroxysmal positional vertigo (HC-BPPV).

Methods

In our prospective study, we performed a testing profile (PSN, BLT, LDN, SRT) on 59 HC-BPPV patients using videonystagmography. We compared the accuracy and sensitivity of these tests in HC-BPPV lateralization. Data from 30 healthy patients were collected as the control group.

Results

When performing positional tests, the elicited nystagmus coinciding with Ewald’s second law was defined as a “positive response”. In 44 patients with geotropic nystagmus, the rates of positive response in LDN, PSN, and BLT were 22/44 (50%), 19/44 (43%), and 18/44 (41%), respectively, while in 15 patients with apogeotropic nystagmus, the positive response rates of these three tests were 10/15 (66.7%), 9/15 (60%), and 4/15 (27.00%), respectively. The sensitivity of LDN (54.38%) was higher than that of PSN (47.37%) and BLT (38.60%) but lower than that of SRT (89.47%). Notably, the accuracy rate of PSN (71.8%) was higher than that of the other APTs. In 6 patients with symmetrical nysgtamus during the roll test, 5 patients showed a positive response in both LDN and BLT (83.34%), whereas 4 patients showed a positive response in PSN (66.67%).

Conclusion

All positional tests are helpful for determining the affected side of HC-BPPV, but SRT carries the highest accuracy of lateralization followed by PSN.

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Acknowledgments

The authors thank the Department of Audiometry and Vestibular Center of Tongji Hospital for supporting this work.

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Author notes

  1. The authors contributed equally to this study.

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Geeta Koju, Dan Bing, Liang-qiang Zhou, Zhong-yao Mao, Yan-ling Tao, Qing-guo Chen, Jin Chen, Yun Liu, Ting Tong & Han-qi Chu

Authors
  1. Geeta Koju
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  2. Dan Bing
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  3. Liang-qiang Zhou
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  4. Zhong-yao Mao
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  5. Yan-ling Tao
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  6. Qing-guo Chen
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  7. Jin Chen
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  8. Yun Liu
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  9. Ting Tong
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  10. Han-qi Chu
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Corresponding author

Correspondence to Han-qi Chu.

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Conflict of Interest Statement

The authors have declared that no competing interests exist. The funders have had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

This work was supported by grants from the National Natural Science Foundation of China (No. 81500794, No. 81271078 and No. 81500791) and Scientific Research Project of Hubei Province Health and Family Planning (No. WJ2015MB062).

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Koju, G., Bing, D., Zhou, Lq. et al. Comparisons of Supine Roll Test and Alternative Positional Tests in HC-BPPV Lateralization. CURR MED SCI 42, 613–619 (2022). https://doi.org/10.1007/s11596-022-2562-z

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  • DOI: https://doi.org/10.1007/s11596-022-2562-z

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