Vestibular recruitment: new application for an old concept

•Post caloric recruitment index is the ratio of the angular velocity of the slow phase obtained by cold and warm caloric stimulation of the same ear.•The normal value was established in 17.06%.•Post caloric recruitment index is useful to identify the affected ear separately.•Recruitment suggests tha...

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Bibliographic Details
Published in:	Brazilian journal of otorhinolaryngology Vol. 88; no. Suppl 1; pp. S91 - S96
Main Authors:	Bittar, Roseli Saraiva Moreira, Mezzalira, Raquel, Ramos, Alice Carolina Mataruco, Risso, Gabriel Henrique, Real, Danilo Martin, Grasel, Signe Schuster
Format:	Journal Article
Language:	English
Published:	Brazil Elsevier Editora Ltda 01-11-2022 Elsevier Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial
Subjects:	Caloric test Humans Neurons - physiology Original OTORHINOLARYNGOLOGY Vestibular compensation Vestibular Nerve - physiology Vestibular recruitment Vestibular recruitment Caloric test Vestibular compensation Compensação vestibular Recrutamento vestibular Prova calórica
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Summary:	•Post caloric recruitment index is the ratio of the angular velocity of the slow phase obtained by cold and warm caloric stimulation of the same ear.•The normal value was established in 17.06%.•Post caloric recruitment index is useful to identify the affected ear separately.•Recruitment suggests that central compensation is not complete yet in individuals with vestibular symptoms and peripheral lesion. Vestibular recruitment is a sign of hyperexcitability of central vestibular neurons and may be characteristic of peripheral vestibular damage. To define the post-caloric recruitment index and its ability to predict the stage of vestibular compensation and peripheral lesion. First of all, we demonstrated that larger values in the cold post-caloric stimulation compared to warm stimulation were equivalent to vestibular recruitment observed during the sinusoidal harmonic acceleration test. In the next step, patients with vestibular complaints and asymptomatic controls were submitted to the caloric test. We calculated post-caloric recruitment index for the control group. Among the study group, we analyzed the relation between post-caloric recruitment and unilateral weakness as well as the types of vestibular diagnoses. Mean post-caloric recruitment was 17.06% and 33.37% among the control and study group, respectively. The ratio between post-caloric recruitment and unilateral weakness was 1.3 in the study group. Among recruiting subjects, no significant difference of unilateral weakness from the lesioned or healthy side was observed. We found no differences in vestibular diagnoses between recruiting and non-recruiting subjects. Post-caloric recruitment index identified asymmetric vestibular tonus and central compensation. The normal value was established at 17.06%.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1808-8694 1808-8686 1808-8686
DOI:	10.1016/j.bjorl.2021.04.006