Caloric Stimulation with Water and Air: Responses by Age and Gender

Document Type : Original

Authors

1 Department of Speech and Hearing, Lamar University, Beaumont, TX. USA. Fluminense Federal University, Niteroi, RJ. Brazil.

2 Fluminense Federal University, Niteroi, RJ. Brazil.

Abstract

Introduction:                                                                     
The caloric test is a well-known valuable clinical instrument that can evaluate and quantify the functional status of both lateral semicircular canals. The American National Standard Institute (ANSI) does not include air as a standard method for caloric stimulation due the lack of published data to determine response variability comparable to water. Due the controversy about air irrigators, it is worthwhile to evaluate the presence of differences between the two irrigation methods in caloric response. The goal is to compare, by age group, the post caloric responses with water and air according gender and age.
 
Materials and Methods:
Individuals without otoneurologic complaints were selected and divided in groups. All were submitted to caloric bithermal stimulation with water at temperatures of 44°C and 30°C (Micromedical Technologies, Inc., USA) and air at temperatures of 50°C and 24°C (Micromedical Technologies,
Inc., USA).
 
Results:
91 subjects were evaluated (46 men and 45 women) with a mean age of 43 years old. The caloric response was similar between genders (P=0,958) and no statistical difference was observed comparing both stimulus (P=0,93). It was identified that the Slow-Phase Velocity (SPV) was lower for the group older than 60 years comparing to the other groups.
 
Conclusion:
For the caloric test, the stimulus with air was confirmed as similar as stimulation with water, including absolute values. Lower values for SPV were found for elderly population.

Keywords

References

  1. Sorathia S, Agrawal Y, Schubert MC. Dizziness and the Otolaryngology Point of View. Med Clin North Am. 2018;102(6):1001-1012.
  2. Shepard NT, Jacobson GP. The caloric irrigation test. Handb Clin Neurol. 2016;137:119-31.
  3. Burnette E, Piker EG, Frank-Ito D. Reevaluating Order Effects in the Binaural Bithermal Caloric Test. Am J Audiol. 2018;27(1):104-109.
  4. Gonçalves DU, Felipe L, Lima TM. Interpretation and use of caloric testing. Braz J Otorhinolaryngol. 2008;74(3):440-6.
  5. Lopez C, Blanke O. Nobel Prize centenary: Robert Bárány and the vestibular system. Curr Biol. 2014;24(21):R1026-8.
  6. Fitzgerald G, Hallpike CS. Studies in human vestibular function I: observations on the directional preponderance of caloric nystagmus resulting from cerebral lesions. Brain. 1942;62(2):115-37.
  7. Bell SL, Barker F, Heselton H, MacKenzie E, Dewhurst D, Sanderson A. A study of the relationship between the video head impulse test and air calorics. Eur Arch Otorhinolaryngol. 2015;272(5):1287-94.
  8. Falls C. Videonystagmography and Posturo- graphy. Adv Otorhinolaryngol. 2019;82:32 -38.
  9. Liang YF, et al. Clinical comparative study of caloric test with water or air in healthy individuals and diagnosing study on air caloric test. 2018; 32(15):1130-33.
  10. Jałocha-Kaczka A, Pietkiewicz P, Zielińska-Bliźniewska H, Miłoński J, Olszewski J. Sensitivity evaluation in air and water caloric stimulation of the vestibular organs using videonystagmography. Otolaryngol Pol. 2014;68(5):227-32.
  11. Barros AC, Caovilla HH. From nystagmus to the air and water caloric tests. Braz J Otorhinolaryngol. 2012;78(4):120-5.
  12. Gudziol H, Koch C, Bitter T, Guntinas-Lichius O. Wet air as an alternative to traditional water irrigation during caloric vestibular testing. Laryngoscope. 2012;122(3):703-7.
  13. Jałocha-Kaczka A, Olszewski J, Urbaniak J, Pietkiewicz P. Comparison of water and air caloric stimulation using Videonystagmography. Int J Clin Exp Pathol 2016;9(2):733-741.
  14. American National Standards Institute (ANSI). ANSI/ASA S3.45-2009. Procedures for Testing Basic Vestibular Function. Washington, DC: ANSI; 2009.
  15. Mallinson AI, Longridge NS, Pace-Asciak P, Ngo R. Measuring caloric response: comparison of different analysis techniques. J Vestib Res. 2010; 20(6):419-26.
  16. Sulway S, Whitney SL. Advances in Vestibular Rehabilitation. Adv Otorhinolaryngol. 2019;82: 164-9.
  17. An SY, Kim BJ, Suh MW, Rhee CK, Jung JY. Clinical roles of fixation suppression failure in dizzy patients in the ENT clinic. Acta Otolaryngol. 2014; 134(11):1134-9.
  18. Jongkees LBW, Maas JPM, Philipszoon AJ. Clinical nystagmography. Practica Otorhinolaryngol 1962;24:65-93.
  19. Mucie HL, Sirmans SM, James E. Dizziness: Approach to Evaluation and Management. Am Fam Physician. 2017 ;95(3):154-162.
  20. Kang S, Kim US. Normative data of videonystagmography in young healthy adults under 40years Korean J Ophthalmol.2015;29(2):126-30.
  21. Yetişer S, İnce D. Caloric Analysis of Patients with Benign Paroxysmal Positional Vertigo. J Int Adv Otol. 2017;13(3):390-393.
  22. Takeda T, Makabe A, Hirai C, Tsutsumi T. Determination of the time course of caloric nystagmus in patients with spinocerebellar degeneration using caloric step stimulus procedure. Acta Otolaryngol. 2018;138(1):41-45.
  23. Walther LE, Asenov DR, Di Martino E. Caloric stimulation with near infrared radiation does not induce paradoxical nystagmus. Acta Otorhino- laryngol Ital. 2011;31(2):90-5.
  24. Sichnarek J, Mrazkova E, Zathurecky E, Tomaskova H. Comparing results from vestibular caloric stimulation and vHIT from a specialised outpatient clinic. Int Tinnitus J. 2019; 23(1):
    1-5.
  25. Felipe L, Cunha LC, Cunha FC, Cintra MT, Gonçalves DU. Presbyvertigo as a cause of dizziness in elderly. Pro Fono. 2008; 20(2):99-103.
  26.      Jahn K. The Aging Vestibular System: Dizziness and Imbalance in the Elderly. Adv Otorhinolaryngol. 2019;82:143-149.

 

 

Iranian Journal of Otorhinolaryngology
Volume 33, Issue 2
March and April 2021
Pages 71-77

Files

Share

How to cite

Statistics