ICS Impulse and caloric testing - what to use and when?
The goal of assessing the patient with vestibular symptoms is to determine if the disorder is unilateral or bilateral, what end organ is contributing to the disorder and the severity of the disorder, and assessing recovery after the onset of the disorder.
The caloric test was first described by Bárány in 1906. Before 2011, the caloric test in was the only test which allowed for ear specific testing. In many countries, the reimbursement for performing a caloric does not come close to covering the cost of the test (personnel salary, equipment, space allocated). Reconsider your workflow
Calorics have their place with particular populations since they do test at a lower frequency, but are they the test that is best for every patient? Impulse offers you more diagnostic information, is more patient friendly and is essentially impervious to many of the issues that are affiliated with calorics (attention, temperature transfer, central compensation).
See the video Kamran Barin Ph.D. comparing Head Impulse and Caloric Tests
Diagnostic quick guide – Describing the global trend in vestibular testing
Head Impulse and Caloric tests - Differences in the Operational Frequency Range
Reimbursement for Vestibular Testing – US version
Head-impulse and caloric tests in patients with dizziness - Otol Neurotol. 2003 Nov