背景:热量测试是自20世纪初以来最常用的评估外周前庭功能的测试。然而,视频头脉冲测试,vHIT,在神经学领域获得了突出的地位,因为这是一个更快的检查,更容易执行和不舒服的病人。
目的:为了比较,通过系统回顾和荟萃分析,慢性头晕患者的vHIT测试和热量测试之间的改变病例比例,除了评估vHIT的敏感性和特异性外,以热量测试为黄金标准。
方法:文献检索在PubMed,Scopus,BVS-Bireme,WebofScience,Embase,Cochrane和ProQuest索引数据库,对出版期限没有限制。包含两项测试结果的所有文章都包括在对头晕患者的评估中。两名研究人员从研究中独立进行数据选择和提取,严格遵循研究方案中定义的纳入和排除标准.如果在选择过程中出现分歧,与第三位评估员进行了讨论。
结果:1293篇初始文章中有11篇符合资格标准并进行了分析。对2670例患者进行了评估,其中男性1112人(41.6%),女性1558人(58.4%),平均年龄51.6岁.vHIT中改变结果的比例为21%(95CI9%-33%),和55%的热量测试(95CI43%-67%)。
结论:vHIT不能代替热量测试。这些测试是评估头晕患者的补充,因为他们描述了不同刺激频率范围下壶腹c的音调。在慢性病例中,与热量检测相比,vHIT具有低敏感性和高诊断特异性.
BACKGROUND: Caloric testing is the most frequently used test to assess peripheral vestibular function since the beginning of the 20th century. However, the video head impulse test, vHIT, has gained prominence in the field of neurotology, as it is a faster examination, easier to perform and less uncomfortable for the patient.
OBJECTIVE: To compare, through systematic
review and meta-analysis, the proportion of altered cases between vHIT tests and caloric testing in patients with chronic dizziness, in addition to assessing the sensitivity and specificity of vHIT, with caloric testing as the gold standard.
METHODS: The literature search was carried out in the PubMed, Scopus, BVS-Bireme, Web of Science, Embase, Cochrane and ProQuest indexed databases, with no restrictions regarding the publication period. All articles that contained the results of the two tests were included in the evaluation of patients with dizziness. Two researchers independently conducted data selection and extraction from the studies, strictly following the inclusion and exclusion criteria defined in the research protocol. In case of disagreement during the selection, a discussion was carried out with a third evaluator.
RESULTS: Eleven of the 1293 initial articles met the eligibility criteria and were analyzed. 2670 patients were evaluated, of which 1112 (41.6%) were males and 1558 (58.4%) females, with a mean age of 51.6 years. The proportion of altered results in the vHIT was 21% (95%CI 9% -33%), and 55% in the caloric testing (95%CI 43% -67%).
CONCLUSIONS: The vHIT does not substitute for caloric testing. The tests are complementary in assessing the patient with dizziness, as they describe the tonotopy of the ampullary crest at different frequency ranges of stimulation. In chronic cases, the vHIT has a low sensitivity and high diagnostic specificity in comparison to caloric testing.