Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

The Subjective Visual Vertical and Electrocochleography Tests in Individuals with Meniere's Disease

Document Type : Original

Authors
Hadi Behzad 1
Reza Gharibi 2
Mahmood RezvaniAmin 3
Setareh Kafashan 4
Ali Kamrani 5
1 Department of Audiology, Shahid Beheshti University of Medical Science, Tehran, Iran.
2 Department of ENT, Zahedan University of Medical Science, Zahedan, Iran.
3 Department of Audiology, Zahedan University of Medical Science, Zahedan, Iran.
4 Department of Audiology, Babol University of Medical Science, Babol, Iran.
5 Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
10.22038/ijorl.2024.77606.3604
Abstract
Introduction:
Meniere's disease is an inner ear disorder not associated with central brain structure involvement. Although the ECochG test has been commonly used to diagnose Meniere's disease recently, it has not demonstrated high sensitivity. Therefore, it is recommended that other complementary tests alongside the ECochG test be used to diagnose Meniere's disease. The SVV test has gained popularity recently for this reason, and in this study, it was decided to use the SVV test in both static and dynamic modes, along with the ECochG test, as a tool for diagnosing Meniere's disease and evaluating its diagnostic features.
Materials and Methods:
The study was conducted on 53 patients with confirmed unilateral Meniere's disease and a normal group. Means were calculated with a 95% confidence interval for the groups, and the corresponding graphs were plotted. Independent t-tests were used to examine the difference in SVV results between the normal and Meniere's groups. The ROC curve was then used to determine the cutoff point and calculate.
Results:
After investigating the cutoff point for the three SVV conditions (tilted towards the lesion), a cutoff point of 2.1 degrees with a sensitivity and specificity of approximately 0.7 was identified as the best condition for distinguishing the Meniere's group from the healthy group.
Conclusion:
Finally, based on the findings, it can be concluded that the SVV test has relatively low sensitivity for diagnosing Meniere's disease. Therefore, more than relying solely on its results to identify Meniere's disease is required, and it is suggested that other measures alongside the ECochG and SVV tests be included in future studies for further investigation.
Keywords
Cutoff point
ECochG
Meniere's disease
SVV test
Sensitivity
Subjects
  1. Arenberg IK, Bałkany TJ, Goldman G, Pillsbury III HC. The incidence and prevalence of Meniere’s disease—a statistical analysis of limits. Otolaryngologic clinics of North America. 1980; 13(4):597-601.
  2. Kumagami H, Sainoo Y, Fujiyama D, Baba A, Oku R, Takasaki K, et al. Subjective visual vertical in acute attacks of Ménière's disease. Otology & neurotology. 2009;30(2):206-9.
  3. Minor LB, Schessel DA, Carey JP. Meniere's disease. Current opinion in neurology. 2004; 17(1): 9-16.
  4. Young Y-H, Huang T-W, Cheng P-W. Assessing the stage of Meniere's disease using vestibular evoked myogenic potentials. Archives of Otolaryngology–Head & Neck Surgery. 2003; 129(8): 815-8.
  5. Zarei M, Ghahraman MA, Daneshi A, Memari F, Akbari M, Faghihzadeh S. Comparison of the prevalence and latency of vestibular evoked myogenic potentials in normal participants and symptomatic and asymptomatic Meniere's disease patients. Audiology. 2009;18.
  6. Pagarkar W, Bamiou D-E, Ridout D, Luxon LM. Subjective visual vertical and horizontal: effect of the preset angle. Archives of Otolaryngology–Head & Neck Surgery. 2008;134(4):394-401.
  7. Valko Y, Hegemann SC, Weber KP, Straumann D, Bockisch CJ. Relative diagnostic value of ocular vestibular evoked potentials and the subjective visual vertical during tilt and eccentric rotation. Clinical Neurophysiology. 2011;122(2):398-404.
  8. Brandt T, Strupp M. General vestibular testing. Clinical Neurophysiology. 2005;116(2):406-26.
  9. Akin FW, Murnane OD, editors. Subjective visual vertical test. Seminars in Hearing; 2009: © Thieme Medical Publishers.
  10. Böhmer A, Mast F. Assessing otolith function by the subjective visual vertical. Annals of the New York Academy of Sciences. 1999;871(1):221-31.
  11. Rezvani Amin M, Behzad H. The impact examination of the head tilt size on the subjective visual vertical (SVV) among the normal individuals with ages ranged from 18 to 35 years. Hearing, Balance and Communication. 2022;20(2):129-34.
  12. Böhmer A, Mast F, Jarchow T. Can a unilateral loss of otolithic function be clinically detected by assessment of the subjective visual vertical? Brain research bulletin. 1996;40(5-6):423-7.
  13. FRIEDMANN G. The judgement of the visual vertical and horizontal with peripheral and central vestibular lesions. Brain. 1970;93(2):313-28.
  14. Lopez C, Lacour M, Léonard J, Magnan J, Borel L. How body position changes visual vertical perception after unilateral vestibular loss. Neuropsychologia. 2008;46(9):2435-40.
  15. Fard AH, Yazdani N, Rezazadeh N, Alborzi MS, Bagheban AA. Subjective visual vertical in patients with unilateral definite Meniere's diseases. Auditory and Vestibular Research. 2017;26(2):105-11.
  16. Kingma H. Function tests of the otolith or statolith system. Current opinion in neurology. 2006;19(1):21-5.
  17. Vibert D, Häusler R, Safran A. Subjective visual vertical in peripheral unilateral vestibular diseases. Journal of Vestibular Research. 1999;9(2):145-52.
  18. Durrant JD, Dallos P. Influence of Direct‐Current Polarization of the Cochlear Partition on the Summating Potentials. The Journal of the Acoustical Society of America. 1972;52(2B):542-52.
  19. Aran J-M, Rarey KE, Hawkins JE. Functional and morphological changes in experimental endolymphatic hydrops. Acta oto-laryngologica. 1984; 97(5-6):547-57.
  20. Van Deelen G, Ruding P, Veldman J, Huizing E, Smoorenburg G. Electrocochleographic study of experimentally induced endolymphatic hydrops. Archives of oto-rhino-laryngology.1987;244:167-73.
  21. Dauman R, Aran J-M, de Sauvage RC, Portmann M. Clinical significance of the summating potential in Meniere's disease. Otology & Neurotology. 1988;9(1):31.
  22. Gibson W, Moffat D, Ramsden R. Clinical electrocochleography in the diagnosis and management of Menière's disorders. Audiology. 1977;16(5):389-401.
  23. Eggermont J, Odenthal D. Potentialities of clinical Clinical Otolaryngology & Allied Sciences. 1977; 2(3): 275-86.
  24. Chung W-H, Cho D-Y, Choi J-Y, Hong SH. Clinical usefulness of extratympanic electrocochleography in the diagnosis of Meniere’s disease. Otology & neurotology. 2004;25(2):144-9.
  25. Ferraro JA, City K. Clinical electrocochleography: overview of theories, techniques and applications. Audiology Online. 2000.

 

Iranian Journal of Otorhinolaryngology
Volume 36, Issue 4
July and August 2024
Pages 517-525