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Korean Journal of Otorhinolaryngology-Head and Neck Surgery > Volume 34(3); 1991 > Article
Korean Journal of Otorhinolaryngology-Head and Neck Surgery 1991;34(3): 477-488.
Clinical application of the monothermal caloric test.
Chang Il Cha, Il Hee Hong, Myung Jin Lee, Nam Pyo Hong, Joong Saeng Cho
단일온도의 양자극과 강자극에 따른 온도안진 검사법의 응용
차창일 · 홍일희 · 이명진 · 홍남표 · 조중생
경희대학교 의과대학 이비인후과학교실
ABSTRACT

The most widely used type of caloric test has been the bithermal caloric test. Despite its usefulness in lateralizing vestibular lesions, the bithermal caloric test is unable to distinguish between labyrinthine(sensory of hair cell) and retrolabyrinthine(8th Nerve or CNS) lesion. In 1970, Torok reported that patients with labyrinthine disease showed vestibular recuritment and the patients with retrolabyrinthine disease showed vestibular decuritment on the monothermal caloric test. According to Torok's procedure, the monothermal caloric test was done on 11 normal volunteers and on 35 patients with vertigo. There results obtained were as follows; 1) In as analysis of 35 patientsm 12(34.2%) were diagnosed as a labyrinthine lesion, 9(25.7%) a retrolabyrinthine lesion, 9(25.7%) normal response and 5(15.2%) were categorized as special group. 2) In the labyrinthine group, the clinical diagnosis were Meniere's synd., BPPV, Ramsey-Hunt synd., vestibular neuronitis. 3) In the retrolabyrinthine group, the clinical diagnoses were vestibular neuronitis, BPPV, Ramsey-Hunt syndrome, Bell's palsy, sudden deafness. 4) In 9 patients, the monothermal caloric test failed to show any abnormalities. The major causes were thought to be psychogenic, false negatives, etc. 5) In special group which showed hypoactive and areflexia, 4 of 5 patients showed auditory abnormalities and all patient were accompanied by medical or psychogenic problems. 6) In an analysis of 11 patients with clinical unclassified vertigo, 5 were classified as labyrinthine group, 1 retrolabyrinthine group, 3 normal response and 2 were categorized as special. 7) In differentiation of side involved lesion, the side implies to the side of abnormal outcomes, or to the side of higher ratio in asymmetry group.

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