A new clinical test of Otolith Function in Peripheral Vestib
This recent JAMA Otolaryngology-Head & Neck Surgery study suggests that the video ocular counter-roll (vOCR) test can be performed with a simple bedside maneuver to detect or track loss of otolith function.

Video-oculography (VOG) goggles have been integrated into the assessment of semicircular canal function in patients with vestibular disorders. This study evaluated the use of VOG-based measurement of ocular counter-roll (vOCR) as a clinical test of otolith function.

A case-control study was conducted to compare vOCR measurement among patients at various stages of unilateral loss of vestibular function with healthy controls. The receiver operating characteristic curve method was used to determine the diagnostic accuracy of the vOCR test in detecting loss of otolith function. Participants were recruited at a tertiary center. Participants included 56 individuals with acute, subacute, and chronic unilateral vestibular loss as well as healthy controls. A simple bedside maneuver with en bloc, 30° lateral tilt of the head and trunk was used for vOCR measurement.

Of the 56 participants, 28 were men; the mean (SD) age was 53.5 years. The mean (SD) time of acute unilateral vestibular loss was 9 days in the acute group, 61 days in the subacute group, and 985 days in the chronic group.

--The vOCR test showed a reduction on the side of vestibular loss, and the deficit was greater in patients with acute and subacute vestibular loss than in patients with chronic loss and healthy controls.

--The asymmetry in vOCR between the side of vestibular loss and the healthy side was significantly higher in patients with acute vs chronic loss.

--Overall, the performance of the vOCR test in discriminating between patients with vestibular loss and healthy controls was 0.83.

--The best vOCR threshold to detect vestibular loss at the 30° tilt was 4.5°, with a sensitivity of 80% and specificity of 82%.

The findings of this case-control study suggest that the vOCR test can be performed with a simple bedside maneuver and may be used to detect or track loss of otolith function.

Source: https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/2777673