Dynamic change of vestibular function and the long-term prognosis of vestibular neuritis

Article type: Research Article

Authors: Guo, Ping^{a; c; 1} | Zhao, Jieli^{a; 1} | Jia, Gaogan^{a; c} | Li, Huawei^{a; b; c; d; *} | Li, Wenyan^{a; b; c; d; *}

Affiliations: [a] ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University. Shanghai, PR China | [b] Institutes of Biomedical Sciences, Fudan University, Shanghai, PR China | [c] NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, PR China | [d] The Institutes of Brain Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, PR China

Correspondence: [*] Corresponding authors. Wenyan Li, E-mail: wenyan_li@fudan.edu.cn, Tel.: +86 13761735615. Huawei Li, E-mail: hwli@shmu.edu.cn.

Note: [1] These authors contributed equally to this work.

Abstract: AIM:To comprehensively evaluate the dynamic change of vestibular function during long-term follow-up of vestibular neuritis, as well as the co-relationship with the outcomes of vestibular neuritis (VN), which provides the recommendations for vestibular function tests during the course of VN. METHODS:A prospective cohort study was conducted on 16 patients with acute VN. Caloric test, vHIT, rotatory chair tests, VEMP, dizziness handicap inventory (DHI) score, and dynamic dizzy scales (VAS-DD) was first performed within 7 days of neuritis onset, which were further re-evaluated during the 6–12 months of follow-up. The dynamic changes on multiple objective vestibular examinations were analyzed during the acute and recovery stage of VN. We further evaluated the co-relationship between the vestibular dysfunction scales and the prognosis of VN. RESULTS:In more than 6 months of follow-up, 44% of the ultralow frequency, 94% of the low-to-mid frequency, and 44% of the high-frequency function of the horizontal semicircular canal returned to normal (p < 0.05). The change degree in symmetry of the rotatory chair test was correlated with the gain of the horizontal semicircular canal on the vHIT and the unilateral weakness (UW) value on the caloric test (p < 0.05). The change in DHI score was correlated with the phase; change in VAS-DD level correlated with the symmetry and TC of the rotatory chair test at VN recovery stage (p < 0.05). There was no significant correlation between the change in DHI score or change in VAS-DD and the degree of vestibular function recovery (p > 0.05). CONCLUSION:In general, vestibular function improved during the course of VN. The rotatory chair test can be used to evaluate the overall function of the vestibular system and the compensatory state in patients with VN.

Keywords: Rotatory chair test, VEMP, vHIT, caloric test, vestibular neuritis

DOI: 10.3233/VES-220104

Journal: Journal of Vestibular Research, vol. 33, no. 6, pp. 411-422, 2023