Caloric testing and the video head impulse test (vHIT) assess vestibular function at different frequency ranges and provide complementary information in patients with acute vertigo. Although a canal paresis (CP) threshold of 25% is commonly used to define caloric abnormality, interpreting CP values in relation to vHIT-defined unilateral high-frequency vestibular dysfunction remains clinically challenging....
✦ The floor
Discussion
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Caloric and vHIT thresholds may not always agree in acute unilateral vestibular dysfunction; clinicians should be cautious about relying on either test alone — but specific threshold cut-offs from this single retrospective study are not yet ready to change established testing protocols.
Defining the relationship between caloric canal paresis thresholds and vHIT gains is essential for standardising how audiologists and neuro-otologists diagnose and classify acute unilateral vestibular loss.
- 01Retrospective design comparing caloric canal paresis (CP) thresholds with vHIT gain ratios in acute unilateral vestibular dysfunction (AUVD).
- 02Caloric and vHIT tests assess different frequency ranges of vestibular function and may capture distinct aspects of loss.
- 03Discordant results between caloric and vHIT tests appear clinically relevant and are quantified in relation to AUVD severity.
- 04Findings suggest that using a single test alone may misclassify some patients with AUVD.
- 05Study is retrospective and uncontrolled, limiting generalisability of any proposed threshold values.
Caloric canal paresis thresholds and vHIT findings provide complementary, not interchangeable, measures of vestibular function in acute unilateral vestibular dysfunction.
studypartially supportedDiscordance between caloric and vHIT results occurs in a clinically meaningful proportion of patients with AUVD.
studypartially supported- PMID
- 42806968
- DOI
- 10.3389/fneur.2026.1893212.
- Journal
- Frontiers in Neurology
- Publication type
- research_article
- Evidence level
- 4
- Population
- Patients with acute unilateral vestibular dysfunction undergoing both caloric and vHIT testing
- Intervention
- Caloric canal paresis threshold measurement
- Comparator
- Video head impulse test (vHIT) gain ratios
Primary outcomes
Agreement between caloric canal paresis thresholds and vHIT-defined vestibular dysfunction severity; Rate of discordance between caloric and vHIT results in AUVD