# Prognostic value of the video head impulse test in sudden sensorineural hearing loss with vertigo: a systematic review and meta-analysis

## TL;DR

This study shows that the video head impulse test can predict hearing recovery in patients with sudden hearing loss and vertigo.

## Contribution

The study identifies posterior semicircular canal dysfunction as a strong predictor of poor hearing recovery in SSNHL-V patients.

## Key findings

- Posterior semicircular canal impairment is more common in SSNHL-V patients than other canals.
- Reduced posterior semicircular canal gain increases the risk of poor hearing recovery by 4.14 times.
- Horizontal semicircular canal dysfunction also correlates with worse hearing outcomes.

## Abstract

To characterise the pattern of video head impulse test (vHIT) impairments in patients with sudden sensorineural hearing loss with vertigo (SSNHL-V), and to assess its correlation with audiological prognosis.

We systematically searched four databases (PubMed, Embase, Scopus, Cochrane Library) from inception to February 24, 2025, performed meta-analysis using Stata 18, and had the protocol prospectively registered with PROSPERO (CRD420251025900).

Among patients with SSNHL-V, impairment of the posterior semicircular canal (PSCC) was found to be more common than that of the horizontal semicircular canal (HSCC) or anterior semicircular canal (ASCC). The pooled prevalence of PSCC abnormality was 50% (95% CI: 0.40–0.60; I2 = 87.65%, z = 14, p < 0.05). Regarding auditory prognosis, patients with reduced PSCC gain on vHIT had a 4.14-fold increased risk of poor hearing recovery (95% CI: 2.64–6.51; I2 = 7%, p = 0.36; z = 6.17, p < 0.05). Similarly, reduced HSCC gain was associated with a 3.06-fold increased risk (95% CI, 1.72–5.44; I2 = 0%, p = 0.96; z = 3.82, p < 0.05).

In patients with SSNHL-V, vHIT assessment revealed a higher rate of PSCC dysfunction compared to other semicircular canals, and impaired PSCC function serves as a significant predictor of auditory prognosis.