ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neuro-Otology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1651714
This article is part of the Research TopicMeniere’s Disease: From Diagnosis to TreatmentView all 14 articles
Defining diagnostic thresholds for dissociation between caloric test and vHIT in Ménière’s disease
Provisionally accepted
- 1Gangnam Severance Hospital Department of Otorhinolaryngology, Gangnam-gu, Republic of Korea
- 2Yonsei University College of Medicine Department of Otorhinolaryngology, Seodaemun-gu, Republic of Korea
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Objective: Ménière's disease (MD) presents with episodic vertigo, hearing loss, and tinnitus; however, its diagnosis remains challenging owing to symptom overlap with other vestibular disorders. We evaluated the diagnostic value of dissociation between caloric test and video head impulse test (vHIT) results in MD compared to vestibular schwannoma (VS) and benign paroxysmal positional vertigo (BPPV).Methods: A retrospective analysis included 195 patients with MD (n = 51), VS (n = 112), or BPPV (n = 32). Vestibular function was assessed using caloric tests and vHIT. Dissociation was defined as an abnormal caloric response (canal paresis [CP] > 25%) with a normal vHIT gain (> 0.80). Diagnostic accuracy was assessed using diagnostic odds ratio (DOR) and receiver operating characteristic curves.Results: Dissociation was more frequent in MD (56.9%) than in VS (25.0%) or BPPV (9.4%) (p < 0.001). It effectively distinguished MD from BPPV (DOR = 12.74) but was less useful for MD vs. VS (DOR = 3.96). CP differentiated MD from BPPV but not VS.Dissociation between caloric and vHIT results is a specific indicator of MD, aiding differentiation from BPPV. However, its utility for distinguishing MD from VS is limited.
Keywords: Ménière's disease, vestibular function, Caloric test, Video head impulse test, Diagnostic accuracy
Received: 22 Jun 2025; Accepted: 07 Aug 2025.
Copyright: © 2025 Cheon, Park, Lee and Bae. 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: Seong Hoon Bae, Gangnam Severance Hospital Department of Otorhinolaryngology, Gangnam-gu, Republic of Korea
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