Research in Vestibular Science

Original Articles

The clinical significance of arterial stiffness in the differential diagnosis of vertigo: Bang-Hoon Cho, Jae-Myung Kim, Young-In Kim, Seung-Han Lee; Res Vestib Sci. 2024;23(1):16-23. Published online March 15, 2024; DOI: https://doi.org/10.21790/rvs.2024.003

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Abstract PDF Supplementary Material: Objectives
Pulse wave velocity (PWV) is a known indicator of arterial stiffness reflecting vascular damage. However, there are few reports of the relationship between PWV and dizziness/vertigo of a vascular origin. We investigated whether the PWV value could be useful as an ancillary measurement for identifying the etiology of dizziness/vertigo.
Methods
We enrolled dizzy patients from March 2016 to December 2018. The patients with posterior circulation stroke presenting with dizziness/vertigo were categorized as having central vertigo. The patients with vertigo due to benign paroxysmal positional vertigo, Ménière disease, or acute unilateral vestibulopathy were categorized as having peripheral vertigo. The PWV value, ankle-brachial index (ABI), and traditional vascular risk factors were collected.
Results
We consecutively enrolled a total of 93 participants. The PWV values were higher in the central vertigo group (p<0.001), but ABI did not differ between the groups. Among the vascular risk factors, the number of patients with diabetes mellitus, dyslipidemia, and male patients was significantly higher in the central vertigo group. The brachial-ankle PWV (baPWV) values were higher in the central vertigo group, even after adjusting for confounding factors (p<0.01). The receiver operating characteristic curve showed that the sensitivity was 74% and specificity was 81% when the mean baPWV value was 14.78 m/sec.
Conclusions
Increased baPWV values were observed in patients with dizziness/vertigo due to stroke. Measurement of the baPWV value could be an ancillary test for evaluating the cause of dizziness/vertigo, even though more convincing evidence is still required.

Comparison of vestibular evoked myogenic potentials between low and high tone idiopathic sudden sensorineural hearing loss: Sang-Wook Park, Sang Yun Lee, Somi Ryu, Jung Woo Lee, Chae Dong Yim, Dong Gu Hur, Seong-Ki Ahn; Res Vestib Sci. 2024;23(1):11-15. Published online March 15, 2024; DOI: https://doi.org/10.21790/rvs.2024.001

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Abstract PDF: Objectives
Vestibular evoked myogenic potentials (VEMP) have been reported to be useful in evaluating not only vestibular function but also the prognosis of idiopathic sudden sensorineural hearing loss (ISSNHL) patients. Even though low frequency, high frequency, and all frequency-involved ISSNHL groups tend to show varied clinical characteristics, there is a lack of data using VEMP results to analyze these subgroups. We investigated if the VEMP test is a valuable tool to predict recovery from hearing loss in association with different frequencies.
Methods
A total of 26 ISSNHL patients were divided into three different groups impaired with low tone (ascending type), high tone (descending type), and all tones (flat type) based on the initial audiograms. Each group included five, 10, and 11 patents, respectively, and their VEMP results were compared between the three subgroups.
Results
Abnormal VEMP results were found in five of the total 26 ISSNHL patients (19.2%). Two (40.0%), one (10.0%), and two (18.1%) patients of low tone, high tone, and all tone hearing loss groups, respectively, showed abnormal VEMP results. However, there was no statistically significant difference between the three groups.
Conclusions
Even though VEMP is known as a valuable tool for predicting the prognosis of ISSNHL patients, it does not seem to reflect frequency-sensitive aspects of ISSNHL.

Unilateral Vestibulopathy Mimicking Inner Ear Ischemia Modeling Using Photothrombosis and Behavioral Assessment Using EthoVision: Min Seok Song, Min Young Lee, Ji Eun Choi, So-Young Chang, Jae-Hun Lee, John Patrick Cuenca, Nathaniel T. Carpena, Jae Yun Jung; Res Vestib Sci. 2023;22(4):112-119. Published online December 15, 2023; DOI: https://doi.org/10.21790/rvs.2023.22.4.112

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Abstract PDF: Objectives
Inner ear ischemic animal models using photochemical reactions have been devised in various ways. Localized vascular ischemia occurs with 532-nm laser irradiation after systemic rose bengal injection, a known photothrombotic mechanism. The aim of this study is to evaluate a photothrombosis-induced vestibulopathy mimicking behavioral changes in the inner ear ischemia model.
Methods
Seven-week-old male Spraque-Dawley rats were used. Animals were divided into three groups: control group (n=6), sham laser group (n=9), and laser group (n=9). To induce the photothrombosis, animals were injected with rose bengal into the femoral vein and then were irradiated with a 532-nm laser (175 mW for 900 seconds) via transtympanic membrane. To investigate the vestibulopathy after photothrombosis, the behavior tests (tail lift reflex test, air righting reflex test, rotarod test) were performed on the 1st, 3rd, and 7th days after surgery. Additionally, an open field test was conducted and analyzed using EthoVision XT (Noldus).
Results
The laser group exhibited significant behavioral change to mimic vestibulopathy in all assessments. Inducing photothrombosis with rose bengal caused severe gait instability, which precluded rotarod testing. In the tail lift reflex test, the laser group displayed vestibular dysfunction with a lower angle formation compared to the control rats. During the open field test, the laser group exhibited reduced mobility, a condition that persisted in the laser groups for 7 days.
Conclusions
Noninvasive laser irradiation using rose bengal and a 532-nm laser induces photothrombosis in the inner ear of animals, leading to the development of vestibulopathy mimicking imbalanced behavior.

Efficacy of the Fixation Index of Bithermal Caloric Test for Differentiating Brain Lesions in Vestibular Disoder: Young Jae Lee, Wonyong Baek, Sung-Il Cho, Gi-Sung Nam; Res Vestib Sci. 2023;22(4):106-111. Published online December 15, 2023; DOI: https://doi.org/10.21790/rvs.2023.22.4.106

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Abstract PDF: Objectives
This study was performed to investigate the efficacy of the fixation index (FI) of the bithermal caloric test for differentiating brain lesions in vestibular disorder.
Methods
We reviewed the medical records of 286 consecutive dizzy patients who underwent brain magnetic resonance imaging (MRI) and the bithermal caloric test at department of otorhinolarnygology. Central vestibulopathy (CVP) was defined as when corresponding lesion was identified on brain MRI, otherwise peripheral vestibulopathy (PVP) was defined. The FI was defined as the mean slow phase velocity (SPV) with fixation divided by the mean SPV without fixation, and failure was indicated when the FI exceeded 70%.
Results
The CVP confirmed by brain MRI and PVP were 16.8% and 83.2%, respectively. The most common CVPs were cerebellopontine angle tumor (n=19, 39.6%) and chronic cerebellar infarction (n=18, 37.5%). There were 23 cases of CVP (47.9%) and 47 cases of PVP (19.7%) with abnormal number of FI in at least two of the four caloric irrigations. The FI score of right cool (RC), left cool (LC), and right warm (RW) were also increased significantly in patients with CVP (p=0.031 at RCFI, p=0.014 at LCFI, p=0.047 at RWFI, and p=0.057 at LWFI; Mann-Whitney U-test).
Conclusions
If two or more abnormal FIs are detected during bithermal caloric testing, there is a high likelihood of CVP. Consequently, additional brain MRI may be necessary for further evaluation.

Clinical Outcomes of Endolymphatic Sac Decompression Surgery in Menière’s Disease: Hee Won Seo, Young Sang Cho, Won-Ho Chung; Res Vestib Sci. 2023;22(4):97-105. Published online December 15, 2023; DOI: https://doi.org/10.21790/rvs.2023.22.4.97

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Abstract PDF: Objectives
Endolymphatic sac decompression surgery (ESDS) is one of the surgical methods for intractable Menière’s disease (MD), and it is known as a relatively safe treatment that does not cause hearing loss. However, the effectiveness and the degree of vertigo control rate of ESDS are still controversial. In this study, we aimed to evaluate the clinical outcomes of ESDS in intractable MD.
Methods
We retrospectively reviewed 33 patients who underwent ESDS for intractable MD from January 2002 to March 2022. Clinical characteristics of patients, pure tone threshold, medical treatment method, and number of vertigo attacks before and after surgery were assessed. The improvement of hearing and vertigo was evaluated according to the 1995 American Academy of Otolaryngology-Head and Neck Surgery criteria.
Results
Of the 33 patients, the average follow-up period was 21.2 months, with immediate follow-up within 2 months (28 patients), short term between 2 and 6 months (27 patients), and long term at 12 months or later (29 patients). In the immediate hearing threshold, both air conduction and bone conduction showed slight deterioration, but there was no significant change in the long-term hearing threshold. At long-term follow-up, 12 patients (41.4%) were able to live without medication, and 18 patients (62.1%) showed improvement in their vertigo symptoms. In addition, patients who showed improvement in hearing also showed improvement in vertigo at the same time.
Conclusions
ESDS in intractable MD is a relatively safe and effective treatment method for reducing vertigo attack without worsening hearing threshold.

Quantifying the Prevalence of Acute Vestibular Neuritis through Big Data Analysis: Chul Young Yoon, Seulgi Hong, Ji-Yun Park, Young Joon Seo; Res Vestib Sci. 2023;22(3):68-76. Published online September 15, 2023; DOI: https://doi.org/10.21790/rvs.2023.22.3.68

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Abstract PDF Supplementary Material: Objectives
Big data analytics in healthcare research have gained momentum, offering unprecedented opportunities to investigate complex medical conditions like acute vestibular neuritis (AVN). However, an inappropriate definition can introduce bias and inaccuracies into prevalence estimation, making the results unreliable and hindering cross-study comparisons. The Health Insurance data in South Korea will be used to create a robust operational definition for AVN.
Methods
The study utilized the National Patients Sample dataset from the Health Insurance Review and Assessment Service (HIRA) of the Republic of Korea. The operational definition of AVN was defined using the HIRA data, which includes specific codes for diagnosis, testing, and medications. The revised categorization scheme for AVN was presented as case 1 through case 5, with criteria for each category.
Results
The optimal conditions are deemed to be those that encompass the outcomes of both case 5 and case 1-1, encompassing all conditions. The study also provided prevalence estimates for subgroups based on demographic factors (age, sex), and found a consistent pattern throughout all years, sex, and age.
Conclusions
The study analyzed the prevalence of AVN in case 1 and case 5, which were similar to the reference prevalence of 3.5 per 100,000 people reported in other countries. The study’s results are encouraging for several reasons, including the validity of the operational definitions used, and the agreement between the study’s prevalence estimates and the reference prevalence. The operational definition in statistics, in the context of big data, serves as a precise and standardized criterion.

Re-fixation Saccade at Video-Head Impulse Test in Patients with Sudden Sensorineural Hearing Loss: Dong Hyuk Jang, Sun Seong Kang, Hyun Joon Shim, Yong-Hwi An; Res Vestib Sci. 2023;22(2):46-51. Published online June 15, 2023; DOI: https://doi.org/10.21790/rvs.2023.22.2.46

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Abstract PDF: Objectives
This study was performed to evaluate characteristics and their prognostic value of video-head impulse test (vHIT) in sudden sensorineural hearing loss (SSNHL) with vertigo.
Methods
Of the 612 patients with a diagnosis of SSNHL from 2010 to 2018, 110 patients (18.0%) with vertigo and 39 patients (6.4%) with vHIT results were recruited. The patients were evaluated for their pure-tone hearing average (at initial, 1-month, and 6-month visit), the presence of re-fixation saccade and gains at vHIT, the canal paresis (CP) at ccaloric test.
Results
Patients with saccade (+) showed higher pure-tone averages than those with saccade (‒) on initial and follow-up audiograms. The improvement in pure-tone averages was less in the saccade (+) group than in the saccade (‒) group. There was no significant difference of hearing recovery between SSNHL patients with normal gain and those with decreased gain. There was no difference of hearing improvement between CP (+) and CP (‒) groups according to the presence of re-fixation saccade.
Conclusions
Concurrent re-fixation saccade at vHIT is a negative prognostic factor of hearing function in SSNHL. Re-fixation saccade in SSNHL may suggest widespread damages to both the cochlea and the vestibule, leading to the poor prognosis.

A Comparative Analysis of the Vestibulocochlear Function in Patients with Isolated Semicircular Canal Hypofunction Using a Video Head Impulse Test: Yu Jung Park, Min Young Lee, Ji Eun Choi, Jae Yun Jung, Jung Hwa Bahng; Res Vestib Sci. 2023;22(2):34-45. Published online June 15, 2023; DOI: https://doi.org/10.21790/rvs.2023.22.2.34

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Abstract PDF: Objectives
The objective of this study was to analyze vestibulocochlear function results in patients identified with isolated semicircular canal (SCC) hypofunction using the video head impulse test (vHIT).
Methods
A retrospective review was conducted on the clinical records of 123 patients diagnosed with isolated SCC hypofunction based on vHIT results. Among these patients, 72 had isolated posterior SCC (PSCC) hypofunction, 25 had isolated lateral SCC (LSCC) hypofunction, and 26 had isolated anterior SCC (ASCC) hypofunction. Descriptive analyses were performed on various vestibulocochlear tests including pure tone audiometry, sinusoidal harmonic acceleration (SHA), spontaneous nystagmus (SN), head-shaking nystagmus (HSN), caloric testing, and cervical vestibular evoked myogenic potential, with results analyzed separately for each SCC hypofunction group.
Results
The study found that 66.0% of the evaluated patients exhibited abnormal results in at least one vestibulocochlear function test. PSCC hypofunction patients showed a significantly higher incidence of hearing loss compared to ASCC and LSCC hypofunction patients. LSCC hypofunction patients exhibited higher rates of corrective saccade, phase asymmetry of SHA, and SN abnormalities compared to other SCC hypofunction patients. Additionally, the rates of corrective saccade and phase asymmetry of SHA were also higher in LSCC hypofunction patients. ASCC hypofunction patients demonstrated significantly higher rates of normal corrective saccade, phase lead of SHA, and SN.
Conclusions
The analysis of this study suggests that even in cases where vHIT indicates isolated SCC hypofunction, additional vestibulocochlear function tests should be conducted to identify any associated vestibulocochlear dysfunctions. This highlights the importance of comprehensive evaluation to accurately diagnose and manage patients with SCC hypofunction.

Clinical Characteristics of Benign Paroxysmal Positional Vertigo Positive on Bilateral Dix-Hallpike Test: Youngrok Jo, Gun Min Lee, Youn Jin Cho, Mi Joo Kim, Minbum Kim; Res Vestib Sci. 2023;22(1):14-18. Published online March 13, 2023; DOI: https://doi.org/10.21790/rvs.2023.22.1.14

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Abstract PDF: Objectives
The purpose of this study is to investigate the clinical characteristics of benign paroxysmal positional vertigo (BPPV) which showed torsional nystagmus on bilateral Dix-Hallpike test, and to analyze the clinical features of pseudo-bilateral BPPV.
Methods
This study is a retrospective chart review of a total of 341 patients diagnosed with BPPV of posterior canal (PC-BPPV). Among them, patients who showed torsional nystagmus on bilateral Dix-Hallpike test were defined as “bilateral DixHallpike positive patients,” who were classified into true- and pseudo-bilateral PC-BPPV group through analysis of nystagmus direction. And pseudo-bilateral PC-BPPV were categorized into two subtypes according to their pathomechanisms. Clinical characteristics including sex, age, underlying vestibular disorders, recurrence and the number of Epley maneuvers were analyzed. Student t-test and Mann-Whitney U-test were used for statistical analysis.
Results
Among 341 patients, 27 patients (7.9%) were “bilateral Dix-Hallpike positive patients”. They received more Epley maneuvers than the group of unilateral PC-BPPV until the resolution of nystagmus (2.3 vs. 1.4, p＜0.001). Fifteen patients out of 27 were diagnosed with pseudo-bilateral PC-BPPV, who were classified into two subtypes according to their pathomechanisms. The number of Epley maneuvers was not different between true- and pseudo-bilateral PC-BPPV.
Conclusions
Patients with pseudo-bilateral PC-BPPV were common among “bilateral Dix-Hallpike positive patients.” For their better treatment, understanding of possible pathophysiology, accurate Dix-Hallpike test and detailed analysis of nystagmus direction are necessary.

Dizziness in Patients with Vestibular Epilepsy: Wankiun Lee, Jae-Moon Kim; Res Vestib Sci. 2023;22(1):7-13. Published online March 13, 2023; DOI: https://doi.org/10.21790/rvs.2023.22.1.7

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Abstract PDF: Objectives
Vestibular epilepsy refers to epilepsy in which vertigo is the sole or main symptom of a seizure. However, epilepsy is rarely considered as a differential diagnosis in patients complaining of dizziness. Here, we reviewed ten cases of vestibular epilepsy and analyzed the dizziness complained by the patient.
Methods
In this study, the medical records of dizziness patients with epileptic discharges observed on electroencephalogram were retrospectively analyzed. Patients who had other obvious causes of dizziness, lacked a description of dizziness, or were not taking antiseizure medications were excluded. We finally recruited 10 patients, and investigated their dizziness characteristic, brain imaging tests, electroencephalograms, and blood test findings.
Results
Patients with vestibular epilepsy usually felt dizzy abruptly while not moving, and often complained of dizziness in the form of spinning around or becoming dazed. Dizziness was short, usually between a few seconds and a few minutes, and the frequency of occurrence was variable, so there was no consistent trend. There were no abnormal findings in blood tests. In brain imaging test, most patients did not show significant abnormalities. The electroencephalographic abnormalities of the patients were mainly observed in the temporal lobe, and the dizziness they complained of improved when they started taking antiseizure medications.
Conclusions
If a patient with dizziness complains of dizziness that occurs suddenly and lasts for a short time, early electroencephalogram should be considered to prevent the diagnosis of epilepsy from being overlooked or delayed.

Development of An Algorithm for Slippage-Induced Motion Artifacts Reduction in Video-Nystagmography: Yerin Lee, Young Joon Seo, Sejung Yang; Res Vestib Sci. 2022;21(4):104-110. Published online December 15, 2022; DOI: https://doi.org/10.21790/rvs.2022.21.4.104

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Abstract PDF: Objectives
The slippage of the video-nystagmography devices causes motion artifacts in the trajectory of the pupil and thus results in distortion in the nystagmus waveform. In this study, the moving average was proposed to reduce slippage-induced motion artifacts from the real-world data obtained in the field.
Methods
The dataset consists of an infrared video of positional tests performed on eight patients with a lateral semicircular canal benign paroxysmal positional vertigo. The trajectories of the pupil were obtained from the video with binarization, morphological operation, and elliptical fitting algorithm. The acquired data was observed and the section where the slippage occurred was labeled by an otolaryngologist. The moving average with windows of various lengths was calculated and subtracted from the original signal and evaluated to find the most adequate parameter to reduce the motion artifact.
Results
The period of nystagmus in the given data was found to be ranged from 0.01 to 4 seconds. The slippages that appeared in the data can be categorized into fast and slow slippages. The length, distance, and speed of trajectories in the slippage ranges were also measured to find the characteristics of the motion artifact in video-nystagmography data. The shape of the nystagmus waveform was preserved, and the motion artifacts were reduced in both types of slippages when the length of the window in moving average was set to 1 second.
Conclusions
The algorithm developed in this study is expected to minimize errors caused by slippage when developing a diagnostic algorithm that can assist clinicians.

The Head-Bending Test in Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo: Sol-lim Choi, Hyun-Sung Kim, Jae-Hwan Choi, Eun Hye Oh; Res Vestib Sci. 2022;21(4):99-103. Published online December 15, 2022; DOI: https://doi.org/10.21790/rvs.2022.21.4.99

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Abstract PDF: Objectives
This study aimed to investigate clinical significance of a head-bending test in benign paroxysmal positional vertigo (BPPV) involving the posterior semicircular canal (PC-BPPV).
Methods
We retrospectively recruited 256 patients with unilateral PC-BPPV between January 2016 and December 2021, and assessed the clinical characteristics of patients showing head-bending nystagmus (HBN).
Results
Of 256 patients, 138 (53.9%) showed HBN. Most patients (n=136, 98.6%) had downbeat nystagmus with (n=38) or without (n=98) torsional component. The remaining two patients had pure upbeat and torsional nystagmus, respectively. The torsional component was directed to the contralesional side in all. Between patients with and without HBN, there were no significant differences in clinical characteristics such as age, lateralization, types of BPPV (canalolithiasis or cupulolithiasis), and success rate of repositioning maneuver.
Conclusions
Head-bending test may be useful in predicting the diagnosis and lateralization of PC-BPPV.

Difference of Cervical Vestibular Evoked Myogenic Potentials between Bone-Conduction and Air-Conduction in Patients with Nonspecific Dizziness: Yong-Hwi An, Jung Ho Choi, Seung Yeon Jeon, Hyun Joon Shim; Res Vestib Sci. 2022;21(4):93-98. Published online December 15, 2022; DOI: https://doi.org/10.21790/rvs.2022.21.4.93

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Abstract PDF: Objectives
This study was performed to evaluate the difference of the cervical vestibular evoked myogenic potentials (cVEMP) stimulated by bone-conduction (BC) and air-conduction (AC) in patients with nonspecific dizziness.
Methods
Twenty-eight dizzy patients (56 ears) and 15 subjects (30 ears) as normal control was enrolled. Responses of BC- and AC-cVEMP were recorded sequentially in both groups. cVEMP parameters including latencies, inter-latencies intervals, amplitudes, and interaural amplitude asymmetry were analyzed and compared.
Results
Among the patients with nonspecific dizziness, AC-cVEMP responses were clearly detected in all 56 ears while BC-cVEMP responses were detected in 32 ears (57.1%). Amplitudes of BC-cVEMP were significantly smaller than those of AC-cVEMP in all patients with BC-cVEMP response. There was no difference in latencies, inter-latencies intervals, and interaural amplitude asymmetry ratios between BC- and AC-cVEMP. There was no significant difference in BCand AC-cVEMP between the dizzy and control groups.
Conclusions
BC-cVEMP is not clinically useful in comparison to AC-cVEMP for the evaluation of nonspecific dizziness. An effective stimulation tool for BC is necessary to provoke more reliable responses of BC-cVEMP.

Assessment of the Vestibuloocular Reflex in Patients with Unilateral Chronic Middle Ear Disease Using the Video Head Impulse Test: A Preliminary Study: Gi-Sung Nam, Wonyong Baek, Sung-Il Cho; Res Vestib Sci. 2022;21(3):80-85. Published online September 15, 2022; DOI: https://doi.org/10.21790/rvs.2022.21.3.80

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Abstract PDF: Objectives
This study aims to investigate the usefulness of the video head impulse test (vHIT) as a method for evaluating vestibular function in patients with unilateral chronic middle ear disease.
Methods
Nineteen patients with various unilateral middle ear diseases including chronic otitis media (COM), COM with cholesteatoma, and adhesive otitis media successfully underwent preoperative vHIT. The gain of vestibuloocular reflex (VOR) and the presence of corrective saccades were compared between the affected ear and the healthy ear.
Results
A total of eight male and 11 female patients with a mean age of 43.1 years were included in this retrospective study. Twelve ears had COM, four had COM with cholesteatoma, and three had adhesive otitis media. A positive history of vertigo or dizziness was reported in 36.8% of the cases. The VOR gain of the affected ears and the healthy ears were 0.97±0.16 vs. 1.00±0.08 in the horizontal canal, 0.91±0.11 vs. 0.87±0.11 in the anterior canal, and 0.87±0.17 vs. 0.99±0.12 in the posterior canal, respectively. Only VOR gain of the posterior canal was significantly decreased compared with healthy ears.
Conclusions
The average VOR gains in the patients with chronic middle ear disease were within the pre-defined values of normality; however, when compared quantitatively, posterior canal gain of affected ears was significantly decreased compared to healthy ears. Our results can be explained by the anatomical proximity of the ampulla of the posterior canal and middle ear space.

Impairment of Vestibular Function in Patients with Vestibular Schwannoma According to the Presence of Dizziness: Youngjeong Lee, Se A Lee, Eek-Sung Lee, Tae-Kyeong Lee, Jong Dae Lee; Res Vestib Sci. 2022;21(3):75-79. Published online September 15, 2022; DOI: https://doi.org/10.21790/rvs.2022.21.3.75

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Abstract PDF: Objectives
Vestibular schwannoma (VS) is a benign Schwann cell-derived slow growing tumor originating from the vestibular nerve. Here, we aimed to investigate the correlation between the presence of the dizziness symptoms and several vestibular function test results.
Methods
We analyzed 32 patients who diagnosed with VS from 2010 to 2021 in our hospital. Caloric test, cervical vestibular-evoked myogenic potential (cVEMP) test, and video head impulse test (vHIT) were analyzed.
Results
Age, sex, pure tone audiometry, and tumor size did not show any statistical significance according to the presence or absence of dizziness. There was also no association between the presence of dizziness symptom or dizziness type and the results of the caloric test, vHIT, and cVEMP test, respectively. However, patients with dizziness had a higher rate of tumors confined to the inner auditory canal than those without dizziness.
Conclusions
In this study, the rate of complaints of dizziness was higer in patients with intracanalicular VS. The diagnostic role of vestibulsr function tests in VS is limited. The dissociation of the results of caloric test, vHIT, and cVEMP test suggest that these test are complementary.

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