Strengths and Clinical applicability
In this study, our population of patients represents a common clinical
scenario in which auditory profiles do not substantially determine
eligibility for further evaluation.
Under normal conditions, a small difference in vestibular excitability
does not alter central vestibular symmetry. In contrast, stronger
stimulation enhances the small imbalance in central vestibular symmetry
that already exists between both labyrinths. . This allows for the VIN
to be used to detect small asymmetries. This property is, in our
opinion, the main strength of the VIN test, and may be taken advantage
of to detect VS, as our results suggest.
This test causes only minor discomfort for the patient, and has high
diagnostic accuracy, and should be considered before referring such
patients out for further imaging. Further studies that include
additional clinical variables may further increase both the sensitivity
and specificity of the VIN test, thus improving the detection of VS in
ASNHL patients.