Is It Possible to Replace Alternative Binaural Bithermal Caloric Test by Monothermal Caloric Test in the Diagnosis of Dizzy Patients? / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: The alternative binaural bithermal (ABB) caloric test by Fitzgerald and Hallpike has become a standard procedure in caloric tests. But it brings patient discomfort and is a time consuming procedure. This study was aimed to investigate the efficacy of the monothermal caloric test as a replacement of ABB caloric test. MATERIALS AND METHOD: The results of 690 complete ABB caloric tests collected from 1997 through 1999 were analyzed retrospectively. We have examined the correlations between canal paresis value (CP) derived from an ABB caloric test and compared with the canal paresis value (CPmono) derived from the monothermal caloric component of a bithermal caloric test. RESULTS: There was a stronger correlation between CP and CPmono of warm monothermal component (Pearson correlation coefficient=0.86) than that of cold monothermal caloric test (Pearson correlation coefficient=0.55). Excluding cases with spontaneous nystagmus (n=553), similar results was observed. A warm monothermal caloric test has higher sensitivity and specificity than a cold monothermal caloric test. When the sensitivity of warm monothermal caloric test was more than 90%, the false positive rate was more than about 20%. The false positive rate was unacceptably high. CONCLUSION: The monothermal caloric test cannot be used as a replacement of ABB caloric test.