Caloric Test vs VHIT – Is Caloric Test Obsolete?

Background: Until recently caloric test has being the gold standard test to evaluate peripheral vestibular paralytic states. However, the new VHIT enables a more accurate, specified evaluation of such conditions which raises the question of the further value of the caloric test.

Objective: To define whether the results obtained from VHIT are in concordance with the caloric test.

Methods: Patients who underwent a standard VNG test including caloric test also underwent VHIT test. The results of the two tests were compared.

Results: Between July 2016 and September 2017 six hundred and sixty five patients were examined in our institution undergoing vestibular function test that included standard VNG including caloric test ant VHIT. Whereas in 545 (82%) patients the results of both test matched (UW in the caloric test and low gain with/or overt saccades), 46 patients (7%) demonstrated UW on the caloric test while having normal VHIT results whereas 74 patients (11%) demonstrated pathological VHIT test with normal caloric test.

Conclusions: VHIT does not replace Caloric test but rather increase our ability to define more accurately our ability to diagnose vestibular paralytic pathologies.