Patient 1. A 25-year-old man presented to the emergency room with an intracranial complication secondary to the chronic otitis media as shown in a CT scan (). He was diagnosed and treated when neurologically stable. In this case the vestibular damage has occurred progressively over many years and as such was successfully compensated. The affected ear was the left; the fistula sign was negative (no nystagmus under rubber bulb applied pressure to the external ear) but the bedside head impulse test was positive due to the appearance of intense refixation saccades that indicated a major vestibular deficit.
Patient 2. A 22-year-old man suffered sudden vestibular damage in the context of his cholesteatomatous chronic otitis media. The fistula test (performed as above) was negative and the bedside head impulse test was positive. With the vHIT we were able to record a very low gain for head impulses towards the affected side with covert and overt refixation saccades as a response to the vestibular deficit and because of the spontaneous nystagmus beating towards the normal ear as well as anticompensatory quick eye movements for head movements towards the nonaffected side ().