Diagnostic Bedside Vestibuloocular Reflex Evaluation in the Setting of a False Negative Fistula Test in Cholesteatoma of the Middle Ear

Figure 2

Case . Video head impulse test of the patient. (a) Rightward head impulses in the plane of the horizontal canal (RHHI) induce a correct response in terms of the gain of the VOR; fast eye movements in the contrary direction of the eye after the reflexive eye movement are seen as part of the spontaneous nystagmus and imbalanced vestibular nuclei function in the acute stage. (b) Leftward head impulses in the plane of the horizontal canal (LHHI) do not evoke a correct eye response; gain is very low and is followed by refixation saccades mixed with the fast phases of the spontaneous nystagmus.

(a)

(b)