Evaluation of c-VEMP and caloric responses of patients diagnosed with posterior channel BPPV

BPPV, which is quite common among vertigo complaints in our society, is a peripheral vestibular system disease. There are two accepted theories in the pathogenesis of this disease: cupulolithiasis and canalolithiasis, depending on the otoconia sticking to the cupula and falling into the semicircular canals. Various repositioning maneuvers have been developed based on these two theories. Diagnosed patients have a high chance of recovery with canal-specific repositioning maneuvers within the scope of vestibular rehabilitation. For this reason, this disease needs to be diagnosed correctly among the patient populations complaining of vertigo. It is known that vestibular tests have a very important place in the diagnosis of bppv. In our study, caloric and c-VEMP findings in posterior canal BPPV were examined and their selectivity and sensitivity were evaluated. 30 patients diagnosed with posterior canal BPPV by Dix-Hallpike test (DHT) were included in the study conducted at Harran University Hospital ENT Clinic. A control group was formed from 30 volunteers who had no history of otological or neurotological diseases. In the cVEMP test; The latencies of P1 and N1 waves, P1-N1 amplitudes and asymmetry rates between the two ears were analyzed. If any of these was abnormal, the result was considered pathological. In the caloric test, canal paresis and direction superiority were evaluated. When canal paralysis was calculated, if the rate was above 25%, it was considered pathological, considering unilateral weakness. In directional superiority, the presence of directional superiority is investigated by comparing the sum of nystagmus hitting the right with the nystagmus hitting the left. If the ratio was above 30%, the presence of directional superiority was considered and the weaker side was considered pathological. In the caloric test, sensitivity was obtained between 0,1729-0,5281, and selectivity was obtained between 0,7793-0,9918. In the c-VEMP test, sensitivity was obtained as 0,1993-0,5614 and selectivity as 0,7793-0,9918. In the evaluation made with the parallel test method, sensitivity 0.406-0,7734 and selectivity 0,6928-0.9624 were obtained. As a result, the chance of detecting BPPV patients was not found to be significant by applying caloric and c-VEMP tests separately; Evaluation by parallel test method was found to be significant.