Standardization of a Cold Caloric Test

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To standardize a cold caloric test, we examined 10 normal persons with a simple cold caloric test (20°C water irrigation for 10 seconds with a 5ml syringe and stimulation for 20 seconds) and 54 normal persons with a cold test with a Nelaton catheter.The simple cold test was then used repeatedly in 90 patients: 17 with accoustic neuroma, 13 with syphilitic labyrinthitis and 64 treated with streptomycin-sulphate.1. The simple cold test showed a stronger response and better reproducibility than the Nelaton catheter methods.2. With reliable thermal stimulation, the response to 20°C stimulation was defined as normal when the maximum eye velocity was not less than 20°/sec and the response difference between the two ears was less than 20°/sec. Pathological responses were classified as moderate CP, severe CP and complete CP.3. Half of the patients examined repeatedly showed pathological responses (49.1% of 180 ears). Of the patients without spontaneous nystagmus 71.9% showed the same results on the second examination, while 63.3% of those who showed spontaneous nystagmus on the first examination and no nystagmus on the second examination.4. All the affected ears of patients with accoustic neuroma showed pathological responses. The intact ears also showed pathological results in 5 patients, but 2 ears recovered postoperatively.5. In patients with syphilitic labyrinthitis, 80.8% of the examined ears showed pathological responses. Streptomycin-treated patients showed a gradual decline of the response, but the lower limit of 1 SD was in the normal range.6. These results indicate that the simple cold test possesses reliable thermal stimulation and good reproducibility. It can be used to diagnose right and left ear lesions separately, and to detect mild and progressive bilateral lesions.
耳鼻咽喉科臨床学会の論文

Standardization of a Cold Caloric Test

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