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KMID : 0361020220650090497
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Korean Journal of Otolaryngology - Head and Neck Surgery
2022 Volume.65 No. 9 p.497 ~ p.502
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Assessing Agreement Between Upright and Supine Head Roll Tests for Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo
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Kim Tae-Ho
Han Jae-Sang
Han Jae-Hong
Lee Dong-Hee
Kim Yeon-Ji
Park Shi-Nae
Park Kyoung-Ho
Seo Jae-Hyun
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Abstract
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Background and Objectives : The newly introduced upright head roll test (UHRT), whichexploits head rotations in the roll plane with the patient in the upright sitting position, is a diagnosticmaneuver for horizontal canal-benign paroxysmal positional vertigo (HC-BPPV).
This study is designed to determine whether UHRT, compared to supine head roll test (SHRT),can more accurately diagnose HC-BPPV and determine the subtype of HC-BPPV.
Subjects and Method : A total of 455 video nystagmus tests performed between April 2019to June 2021 were retrospectively reviewed, and 63 patients with direction-changing positionalnystagmus at UHRT or SHRT were enrolled in this study. UHRT result was classified as negative(if no nystagmus was observed), positive incomplete (if nystagmus was detected in oneside), and positive complete (if nystagmus was evoked in both side). The frequency of nystagmusis also included in our assessment. In addition, the results of 4 patients with bow and leantest (BLT) records on videonystagmography were also analysed.
Results : The concordance rate between UHRT and SHRT was 97.8%, and the positive concordancerate was 91.38%. UHRT and SHRT provided identical subtype diagnosis in 98.1%(52 of 53 cases). In one case, UHRT and SHRT showed opposite results. Evaluating the affectedside with bow and lean records, the SHRT, UHRT and BLT showed consistent results. Themean frequency of nystagmus was faster in SHRT than in UHRT.
Conclusion : UHRT showed equivalent results to SHRT in distinguishing subtype of HCBPPV. UHRT is a useful method in diagnosing HC-BPPV simply in a sitting position.
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KEYWORD
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Benign paroxysmal positional vertigo, Diagnosis, Semicircular canals
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