ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neuro-Otology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1633349
VIDEO HEAD IMPULSE AND SUPPRESSION HEAD IMPULSE TEST IN CHRONIC OTITIS MEDIA PATIENTS ALI YILDIRIM1*, Nebi M. Gumus2, Ece D. Duman1, ilayda Kiran1
Provisionally accepted
- 1DeepSynaps ltd, Oxford, United Kingdom
- 2Istanbul Gelisim Universitesi, Istanbul, Türkiye
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Word count: 210 Background: Chronic otitis media (COM) may silently compromise vestibular function before patients develop overt imbalance. Detecting such subclinical changes is clinically relevant but remains challenging. Objective: This study aimed to determine whether adults with COM exhibit measurable abnormalities of lateral semicircular-canal function when assessed with both the video head-impulse test (vHIT) and the suppression head-impulse paradigm (SHIMP), and to examine whether vestibular metrics relate to hearing status. Methods: We conducted a cross-sectional case–control study of 20 adults with COM (25–55 years) and 20 age-matched healthy controls. All participants underwent pure-tone audiometry, vHIT, and SHIMP testing. Results: Pure-tone thresholds were significantly higher in the COM group across 0.25–8 kHz (p < 0.001). vHIT revealed comparable lateral-canal gains between groups (COM: 0.86 ± 0.06 left, 0.89 ± 0.06 right; controls: 0.88 ± 0.05, 0.90 ± 0.04; both p > 0.05), with no covert or overt refixation saccades. SHIMP, in contrast, demonstrated clear abnormalities: COM ears showed higher canal gains (left p = 0.001; right p = 0.007) and significantly smaller overt saccade amplitudes (left p = 0.001; right p = 0.004). Conclusion: The discordance between normal vHIT and abnormal SHIMP results suggests central compensation for subtle peripheral dysfunction in COM. SHIMP therefore provides complementary sensitivity to hidden vestibular abnormalities. Despite the modest, single-center sample size, these findings support incorporating SHIMP into COM assessment to enable earlier detection and guide vestibular rehabilitation.
Keywords: Ali Yildirim, founder, Deepsynaps Ilayda kiran, researcher, Deepsynaps Ece Damla Duman, Deepsynaps
Received: 22 May 2025; Accepted: 14 Oct 2025.
Copyright: © 2025 YILDIRIM, Gumus, Duman and Kiran. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: ALI YILDIRIM, ali.yildirim@deepsynaps.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.