Comparison between air and water caloric tests in children

The caloric test represents an essential part of each procedure evaluating vestibular function. The use of water has many contraindications: tympanic perforation, external otitis and mastoid diseases. Sometimes, nausea can ma ke test execution very difficult. Several authors contributed to the study and diffusion of the caloric test for the evaluation of labyrinthine functi on using different types of otoalcorimeters. We compared two methods in the child - generally intolerant to the water test - and the results obtained were adapted to a mathematical model of air and water caloric nystagmus. Tw enty-seven normal children, aged between 5 and 14 years, subdivided into th ree age groups (5-7, 8-10 and 11-14 years), underwent the water caloric tes t (250 cm(3) at 31 and 43 degrees C for 40 s) and then the air test, togeth er with another nine subjects undergoing only the air test (flow-rate 8 l/m in at 25 and 49 degrees C) on different days. The comparison between the tw o stimulation methods showed a statistically significant difference (P < 0. 002) between maximum slow speed component (max SSC) in degrees per second ( degrees/s) of water (4.74 degrees/s) and air (2.98 degrees/s). The results of two caloric tests and the interindividual and intraindividual analysis o f our electronystagmographic results are in agreement with the data obtaine d by other authors in studies on adults. Therefore, notwithstanding the dif ferences between the two stimulation methods, the air caloric test can be a pplied in a larger number of cases, it is better tolerated and can thus be used even in children for the study of labyrinthine function. (C) 1999 Else vier Science Ireland Ltd. All rights reserved.