gms | German Medical Science

Caloric testing of the vestibular labyrinth is usually performed by the classic caloric test procedures (CCTP) with water of 30 and 44 °C. Ice water irrigation (4°C) is mostly rejected, although it might be useful as a bedside test. To verify the validity of the Minimal Ice Water Caloric Test (MIWCT), video-oculographic comparative investigations were performed in 22 healthy subjects with ice water (0.5 ml, 1.0 ml, 2 ml), CCTP, and cold air (27°C). “Frequency”, “amplitude”, “slow phase velocity” (SPV), “nystagmusonset” and “-duration” were documented. After addition of three ice cubes, the temperature of conventional tap water (16°C) decreased within 13 min to 4°C. In “pessimum position”, no nystagmus response was observed during “MIWCT”. In comparison to “CCTP”, the “MIWCT” led to a significant later nystagmus onset and a significant prolongation of the nystagmus reaction. In contrast to “air stimulation (27°C)”, the “MIWCT (1 and 2 ml)” showed a significant Spearman’s correlation for all three essential nystagmus parameters (frequency, amplitude and SPV) with the established “CCTP”, which are considered to be the gold standard. Thus, the “MIWCT (1 ml and 2 ml)” in healthy adults suggests that this procedure is suitable as a bedside examination for investigation of vestibular function outside the vestibular laboratory, e.g. on a hospital ward during examination by a consultant, where vestibular testing of bed rest patients with vertigo is sometimes necessary.