Re-fixation Saccade at Video-Head Impulse Test in Patients with Sudden Sensorineural Hearing Loss

Abstract

Objectives: This study was performed to evaluate characteristics and their prognostic value of video-head impulse test (vHIT) in sudden sensorineural hearing loss (SSNHL) with vertigo.Methods: Of the 612 patients with a diagnosis of SSNHL from 2010 to 2018, 110 patients (18.0%) with vertigo and 39 patients (6.4%) with vHIT results were recruited. The patients were evaluated for their pure-tone hearing average (at initial, 1-month, and 6-month visit), the presence of re-fixation saccade and gains at vHIT, the canal paresis (CP) at ccaloric test.Results: Patients with saccade (+) showed higher pure-tone averages than those with saccade (‒) on initial and follow-up audiograms. The improvement in pure-tone averages was less in the saccade (+) group than in the saccade (‒) group. There was no significant difference of hearing recovery between SSNHL patients with normal gain and those with decreased gain. There was no difference of hearing improvement between CP (+) and CP (‒) groups according to the presence of re-fixation saccade.Conclusions: Concurrent re-fixation saccade at vHIT is a negative prognostic factor of hearing function in SSNHL. Re-fixation saccade in SSNHL may suggest widespread damages to both the cochlea and the vestibule, leading to the poor prognosis.