Hallpike’s Caloric Test

2016 ◽  
Author(s):  
Robert W. Baloh
Keyword(s):  
Body Temperature ◽  
Inner Ear ◽  
Caloric Test ◽  
Ear Canal ◽  
Caloric Testing ◽  
Minute Period ◽  
Rapid Flow ◽  
Series Of Experiments ◽  
Directional Preponderance

Charles Hallpike decided that greater precision could be obtained with the caloric test by measurement of one or more attributes of the responses to some suitably graded stimulus. He chose to measure the duration of induced nystagmus. Hallpike chose water at 30°C and 44°C (7°C below and above body temperature, respectively) and allowed it to flow for 40 seconds. These temperatures were generally well tolerated, and the comparatively large quantity of water and rapid flow minimized errors due to misdirecting the stream within the ear canal. A simple chart was used to summarize the results of the bithermal caloric test. The chart consisted of two continuous lines, each representing a total of a 3-minute period, subdivided into 10-second intervals. Hallpike conducted a series of experiments on the phenomenon of directional preponderance with caloric testing and emphasized the importance of vestibular tonus originating from the inner ear receptors.

scholarly journals Directional Preponderance (DP) of Caloric Test in Patients with Various Inner Ear Lesions.

1994 ◽  
Vol 53 (2) ◽  
pp. 247-251
Author(s):  
Motohisa Ikeda ◽  
Isamu Watanabe ◽  
Jiro Muto
Keyword(s):  
Inner Ear ◽  
Caloric Test ◽  
Directional Preponderance

Sonometric Evaluation of Eustachian Tube Function Using Broadband Stimuli

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 178-184 ◽  
Author(s):  
Krishna G. Murti ◽  
Erdem I. Cantekin ◽  
Richard M. Stern ◽  
Charles D. Bluestone
Keyword(s):  
Eustachian Tube ◽  
A Priori ◽  
Broadband Noise ◽  
Ear Canal ◽  
Experimental Conditions ◽  
Diagnostic Significance ◽  
Tube Function ◽  
Series Of Experiments ◽  
Sound Conduction ◽  
Clinical Instrument

New measurements of acoustical transmission through the eustachian tube (ET) have been obtained in a series of experiments directed toward the development of a clinical instrument to assess ET function behind an intact tympanic membrane (TM). Using a sound conduction method, a sound source was placed in one nostril, and the acoustical energy that was transmitted through the ET was measured by a microphone placed in the ear canal. The present study used a broadband noise as the acoustical stimulus, in contrast to the tonal stimuli employed in previous investigations. This stimulus was chosen because it is believed to reduce the variability in the data due to intersubject differences in the acoustics of the nasopharynx and ET, and to avoid any a priori assumptions concerning the specific frequencies that would be of greatest diagnostic significance. Averaged spectra of the sound transmitted to the ear canal were obtained for three experimental conditions: acoustical source present during subject swallowing, source present with no swallowing, and subject swallowing with source absent. A Bayesian classification scheme based on the statistics of these spectra was used in classifying subjects into one of two possible categories, normal and abnormal ET function. A comparison was made between sonometric classification and classification based on a tympanometric ET function test. Correlation between the two methods was 87.1%.

Reference Values for Serial Vestibular Testing

1986 ◽  
Vol 95 (1) ◽  
pp. 83-90 ◽  
Author(s):  
Leonard Proctor ◽  
Robert Glackin ◽  
Craig Smith ◽  
Hiroshi Shimizu ◽  
Paul Lietman
Keyword(s):  
Reference Values ◽  
Test Scores ◽  
Vestibular Function ◽  
Normal Subjects ◽  
Caloric Test ◽  
Initial Value ◽  
Short Acting ◽  
Normal Limits ◽  
Vestibular Testing ◽  
Directional Preponderance

This study defines the normal limits of day-to-day variation in vestibular function. A short-acting caloric test was used and nystagmus intensity was measured by means of an interactive computerized technique. Data were analyzed from 30 normal subjects tested on three successive days and from ten of these subjects who were also tested on 11 additional occasions. Individual caloric test scores generally remained between 55% and 170% of their initial value; narrower ranges resulted when scores were averaged together. There was very little habituation of caloric responses. The upper normal limits of test-retest variation in scores for right-left difference and directional preponderance of caloric responses were 24% and 22%, respectively.

Politzer’s Otology Clinic and the Discovery of the Caloric Test

2016 ◽  
Author(s):  
Robert W. Baloh
Keyword(s):  
Inner Ear ◽  
General Hospital ◽  
Surgical Training ◽  
Nobel Prize ◽  
Caloric Test ◽  
Vestibular Apparatus ◽  
University Of Vienna ◽  
Vienna General Hospital ◽  
Ear Canals ◽  
The University

Robert Bárány began his training in Adam Politzer’s Otology Clinic at the University of Vienna in October 1903 after completing his surgical training at the Vienna General Hospital. During his training, Bárány became friends with Gustav Alexander, who already had been offered a position in Politzer’s clinic. Alexander stimulated Bárány’s interest in the vestibular apparatus of the inner ear and was influential in helping Bárány obtain his appointment in Politzer’s clinic. It was well known in Politzer’s clinic that one had to be extremely careful regarding the temperature of the water used to irrigate the ear canals in removing cerumen, otherwise the patient would become dizzy. Bárány discovered the mechanism of this caloric reaction and eventually received the Nobel Prize in Medicine. Bárány’s findings were considered to be pivotal in clinical otology. His colleagues at the clinic were less magnanimous in their praise of Bárány’s accomplishments and questioned his integrity.

Functional Patency of the Cochlear Aqueduct

1982 ◽  
Vol 91 (2) ◽  
pp. 209-215 ◽  
Author(s):  
Björn Carlborg ◽  
Barbara Densert ◽  
Ove Densert
Keyword(s):  
Cerebrospinal Fluid ◽  
Inner Ear ◽  
Middle Ear ◽  
Ambient Pressure ◽  
Ear Canal ◽  
Cochlear Aqueduct ◽  
Pressure Release ◽  
Release Capacity ◽  
Before And After ◽  
Pressure Changes

The perilymphatic (P P) and cerebrospinal fluid (P CSF) pressures were investigated in relation to pressure variations in the ear canal, middle ear and intracranial compartment before and after occlusion of the cochlear aqueduct (CA). Experiments using intracranial infusion showed that the CA was responsible for a perfect hydrodynamic balance between the CSF and the perilymph. There are indications of additional pressure release factors but their capacities were not sufficient to prevent the appearance of a longstanding and substantial pressure gradient following occlusion of the CA. A gradual P P build-up, from zero to its original level after the CA was opened and occluded, indicated perilymph production within the labyrinth. Investigation of pressure transfer from the ear canal and middle ear to the perilymph showed that the CA was the major pressure release route from the cochlea. Occlusion of the CA reduced the compliance of the inner ear and severely reduced the pressure release capacity. In such a situation the inner ear is almost incapable of equilibrating ambient pressure changes.

Results in caloric test, video head impulse test and inner ear MRI in patients with Ménière’s disease

2020 ◽  
Vol 47 (1) ◽  
pp. 71-78 ◽  
Author(s):  
Koichi Kitano ◽  
Tadashi Kitahara ◽  
Taeko Ito ◽  
Tomoyuki Shiozaki ◽  
Yoshiro Wada ◽  
...  
Keyword(s):  
Inner Ear ◽  
Meniere’S Disease ◽  
Head Impulse Test ◽  
Caloric Test ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Video Head Impulse Test ◽  
Menière's Disease ◽  
Head Impulse ◽  
Ménière's Disease

Evaluation of Vestibular Functions in Patients with Vogt-Koyanagi-Harada Disease

2017 ◽  
Vol 22 (3) ◽  
pp. 190-195 ◽  
Author(s):  
Keishi Fujiwara ◽  
Shinya Morita ◽  
Kimiko Hoshino ◽  
Atsushi Fukuda ◽  
Yuji Nakamaru ◽  
...  
Keyword(s):  
Autoimmune Disorder ◽  
University Hospital ◽  
Caloric Test ◽  
Subjective Symptoms ◽  
Vestibular Evoked Myogenic Potential ◽  
Caloric Testing ◽  
Ocular Vemp ◽  
Cervical Vemp ◽  
Vestibular Symptoms ◽  
Vkh Disease

Vogt-Koyanagi-Harada (VKH) disease is an idiopathic, multisystem autoimmune disorder characterized by bilateral, diffuse granulomatous uveitis associated with neurological, audiovestibular, and dermatological manifestations. The purpose of this study is to investigate vestibular functions in patients with VKH disease. A total of 43 patients with VKH disease in Hokkaido University Hospital were enrolled in this study. Subjective symptoms such as dizziness or vertigo and the results of various vestibular examinations including nystagmus testing, caloric testing, and vestibular-evoked myogenic potential (VEMP) testing were investigated. Eight of 42 patients (19.0%) complained of subjective vestibular symptoms. On the other hand, 12 of 28 patients (42.9%) showed nystagmus, and 7 of 15 patients (46.7%) showed unilateral or bilateral weakness in the caloric test. VEMP testing was performed for 16 patients. Seven (43.8%) and 8 (50.0%) patients were evaluated as abnormal in cervical VEMP and ocular VEMP testing, respectively. The rate of detection of nystagmus was significantly higher than that of subjective symptoms. As vestibular dysfunction in patients with VKH disease cannot be detected through history taking alone, nystagmus testing, caloric testing, and VEMP testing should be performed to evaluate vestibular functions associated with VKH disease. It is considered that abnormal VEMP findings are associated with otolith organ dysfunction.

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