Utility of Video Head Impulse Test in Meniere's Disease: A Systematic Review

Abstract

Introduction: Meniere’s disease is an inner ear disorder characterized by low-frequency sensorineural hearing loss, episodic vertigo, and tinnitus. Video head impulse test is a recent tool that assesses all the six semi-circular canals in individuals with various vestibular pathology. Aim: To systematically review the articles related to video head impulse test findings in patients with definite Meniere's disease. Method: Initially, a review search was performed in different databases. Searches across different databases resulted in 93 topic-related articles. Total nineteen articles met the inclusion and exclusion criteria to meet the objectives of the study. The quality and potential risk associated with each article were evaluated using the QUADAS-2 risk of bias assessment tool. Results: The results of these studies are unequivocally indicating increased, decreased, or normal VOR gain on the side affected with Meniere’s disease. Few studies have found an abnormal decrease in VOR gain as the disease duration increases and also in the advanced stages of the disease. Some authors have reported that the chances of showing reduced VOR gain are more for the posterior semi-circular canals, whereas some other authors showed it on the lateral canals. Presence of a higher proportion of saccades on the affected side compared to the unaffected side. The occurrence of saccades is more in the horizontal canals. Overt saccades are seen more than covert saccades. The majority of the studies showed a dissociation between the vHIT and caloric test results in patients with Meniere’s disease. Conclusion: The video head impulse test is a valuable tool in the diagnosis of Meniere’s disease when used along with other vestibular tests. When there is an involvement of vertical canals, especially the posterior canal, vHIT provides essential information by showing abnormality in at least one of the parameters.