Hot or cold? Is monothermal caloric testing useful and cost-effective?

Matthew L. Bush, Christopher M. Bingcang, Edward T. Chang, Brandon Fornwalt, Christopher Rayle, Thomas J. Gal, Raleigh O. Jones, Jennifer B. Shinn

Research output: Contribution to journalArticle

Abstract

Videonystagmography (VNG) is used widely in the assessment of balance dysfunction. The full test battery can be time-consuming and can induce patient discomfort. The purpose of this study was to examine the value of monothermal caloric testing in predicting unilateral caloric weakness, as well as abnormal VNG vestibular and nonvestibular eye movement, while considering the time and reimbursement associated with these tests. In a retrospective review of 645 patients who completed a comprehensive VNG test battery with bithermal caloric testing, we calculated the specificity, sensitivity, and predictive values of monothermal caloric testing in relation to bithermal caloric results and noncaloric VNG results. With unilateral vestibular weakness (UVW) defined as a 25% interear difference, warm-air monothermal caloric testing yielded a sensitivity of 87% and a negative predictive value of 90% for predicting UVW. With a 10% UVW definition, the warm-air caloric testing sensitivity increased to 95% and the negative predictive value to 92%. Warm-air monothermal caloric testing had a positive predictive value of 85% and a negative predictive value of 18% for predicting noncaloric VNG findings; cold-air monothermal and bithermal testing displayed similar results. Isolated monothermal testing is a sensitive screening tool for detecting UVW, but is not adequate for predicting noncaloric VNG results.

Original languageEnglish (US)
Pages (from-to)412-416
Number of pages5
JournalThe Annals of otology, rhinology, and laryngology
Volume122
Issue number6
StatePublished - Jun 2013
Externally publishedYes

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Air
Costs and Cost Analysis
Eye Movements
Sensitivity and Specificity

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Bush, M. L., Bingcang, C. M., Chang, E. T., Fornwalt, B., Rayle, C., Gal, T. J., ... Shinn, J. B. (2013). Hot or cold? Is monothermal caloric testing useful and cost-effective? The Annals of otology, rhinology, and laryngology, 122(6), 412-416.

Hot or cold? Is monothermal caloric testing useful and cost-effective? / Bush, Matthew L.; Bingcang, Christopher M.; Chang, Edward T.; Fornwalt, Brandon; Rayle, Christopher; Gal, Thomas J.; Jones, Raleigh O.; Shinn, Jennifer B.

In: The Annals of otology, rhinology, and laryngology, Vol. 122, No. 6, 06.2013, p. 412-416.

Research output: Contribution to journalArticle

Bush, ML, Bingcang, CM, Chang, ET, Fornwalt, B, Rayle, C, Gal, TJ, Jones, RO & Shinn, JB 2013, 'Hot or cold? Is monothermal caloric testing useful and cost-effective?', The Annals of otology, rhinology, and laryngology, vol. 122, no. 6, pp. 412-416.
Bush, Matthew L. ; Bingcang, Christopher M. ; Chang, Edward T. ; Fornwalt, Brandon ; Rayle, Christopher ; Gal, Thomas J. ; Jones, Raleigh O. ; Shinn, Jennifer B. / Hot or cold? Is monothermal caloric testing useful and cost-effective?. In: The Annals of otology, rhinology, and laryngology. 2013 ; Vol. 122, No. 6. pp. 412-416.
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