Bilateral simultaneous caloric test for superior semicircular canal evaluation. 2011

Jade Nehme, and Issam Saliba
Department of Otolaryngology-Head and Neck Surgery, Montreal University Hospital Center, Montreal, Quebec, Canada.

OBJECTIVE To verify if the superior semicircular canal (SCC) can be stimulated using the modified "bilateral simultaneous caloric test" (BSCT). METHODS Prospective study in a tertiary care center. METHODS We performed a simultaneous irrigation of both ears with cold water at 24°C. Simultaneous irrigation of both ears inhibits the response of the horizontal SSC and avoids vegetative reaction. Modified BSCT was completed on 12 healthy individuals with no previous otologic history and on 12 patients with unilateral superior SCC obliteration for dehiscence syndrome using a middle fossa approach. Caloric response was recorded in 3 different positions (midline, head rotated to the right and then rotated to the left), and results were compared. RESULTS Nystagmus was vertical and upbeating. In the healthy population, the median intensity of nystagmus was 14.42 ± 7.32, 11, and 10.5 degrees per second for the 3 head positions. In the population with one obliterated superior SCC, the median intensity of nystagmus was 7.58 ± 3.8 degrees per second when the head was in the midline position, 6.0 degrees per second when the healthy superior SCC was stimulated, and 1.5 degrees per second when the obliterated canal was stimulated. Using a nonparametric statistical test, the mean intensity difference was statistically significant between the 2 populations (p < 0.001) and statistically significant between the obliterated and nonobliterated canals (p = 0.003). CONCLUSIONS This study shows that the superior SCC can be specifically stimulated in humans. Modified BSCT can stimulate the superior canal and can provide a good estimation of its stimulation intensity after the surgery.

UI MeSH Term Description Entries
D007759 Labyrinth Diseases Pathological processes of the inner ear (LABYRINTH) which contains the essential apparatus of hearing (COCHLEA) and balance (SEMICIRCULAR CANALS). Inner Ear Disease,Ear Disease, Inner,Ear Diseases, Inner,Inner Ear Diseases,Labyrinth Disease
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009759 Nystagmus, Pathologic Involuntary movements of the eye that are divided into two types, jerk and pendular. Jerk nystagmus has a slow phase in one direction followed by a corrective fast phase in the opposite direction, and is usually caused by central or peripheral vestibular dysfunction. Pendular nystagmus features oscillations that are of equal velocity in both directions and this condition is often associated with visual loss early in life. (Adams et al., Principles of Neurology, 6th ed, p272) Convergence Nystagmus,Horizontal Nystagmus,Jerk Nystagmus,Pendular Nystagmus,Periodic Alternating Nystagmus,Rotary Nystagmus,See-Saw Nystagmus,Vertical Nystagmus,Conjugate Nystagmus,Dissociated Nystagmus,Fatigable Positional Nystagmus,Multidirectional Nystagmus,Non-Fatigable Positional Nystagmus,Permanent Nystagmus,Rebound Nystagmus,Retraction Nystagmus,Rotational Nystagmus,Spontaneous Ocular Nystagmus,Symptomatic Nystagmus,Temporary Nystagmus,Unidirectional Nystagmus,Non Fatigable Positional Nystagmus,Nystagmus, Conjugate,Nystagmus, Convergence,Nystagmus, Dissociated,Nystagmus, Fatigable Positional,Nystagmus, Horizontal,Nystagmus, Jerk,Nystagmus, Multidirectional,Nystagmus, Non-Fatigable Positional,Nystagmus, Pendular,Nystagmus, Periodic Alternating,Nystagmus, Permanent,Nystagmus, Rebound,Nystagmus, Retraction,Nystagmus, Rotary,Nystagmus, Rotational,Nystagmus, See-Saw,Nystagmus, Spontaneous Ocular,Nystagmus, Symptomatic,Nystagmus, Temporary,Nystagmus, Unidirectional,Nystagmus, Vertical,Ocular Nystagmus, Spontaneous,Pathologic Nystagmus,Positional Nystagmus, Non-Fatigable,See Saw Nystagmus
D009760 Nystagmus, Physiologic Involuntary rhythmical movements of the eyes in the normal person. These can be naturally occurring as in end-position (end-point, end-stage, or deviational) nystagmus or induced by the optokinetic drum (NYSTAGMUS, OPTOKINETIC), caloric test, or a rotating chair. Nystagmus, Barany,Nystagmus, Caloric,Nystagmus, End-Position,Nystagmus, Positional,Nystagmus, Post-Rotatory,Nystagmus, Thermal,Nystagmus, Barany's,Nystagmus, Physiological,Physiologic Nystagmus,Barany Nystagmus,Barany's Nystagmus,Caloric Nystagmus,End-Position Nystagmus,Nystagmus, Baranys,Nystagmus, End Position,Nystagmus, Post Rotatory,Physiological Nystagmus,Positional Nystagmus,Post-Rotatory Nystagmus,Thermal Nystagmus
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002150 Caloric Tests Elicitation of a rotatory nystagmus by stimulating the semicircular canals with water or air which is above or below body temperature. In warm caloric stimulation a rotatory nystagmus is developed toward the side of the stimulated ear; in cold, away from the stimulated side. Absence of nystagmus indicates the labyrinth is not functioning. Barany Test,Barany's Test,Baranys Test,Caloric Test,Test, Barany,Test, Barany's,Test, Caloric,Tests, Caloric
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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