Vestibular evaluation consists of a variety of tests to examine and diagnose the vestibular portion of the inner ear, which is responsible for balance. These tests can help find the cause of dizziness or other symptoms in order to determine the best course of treatment.
Some frequently performed vestibular tests include:
- Electronystagmography (ENG) - This is the most common test used to evaluate the vestibular system. Electrodes are taped close to the eyes, and a computer records the results as patients follow a moving light with their eyes while they sit and lie in a variety of different positions. Nystagmus, a type of involuntary eye movement, is driven by the vestibular organs whenever the head is moving. These movements can therefore be used to evaluate the balance system.
- Posturography - The patient stands on a platform that moves back and forth slightly while a visual focus is shown. Sensitive machinery in the platform records each bodily shift. This measures how well patients can maintain their balance. A safety harness is worn to protect the patient from falling.
- Rotational Chair Test - Electrodes are placed near the patient's eyes so that eye movements can be recorded. The patient sits on a chair that gently swivels from side to side while looking at a variety of light patterns. This type of testing is typically performed in a darkened evaluation room.
- Fistula Test - This test is used to detect perilymphatic fistula (PF), a small tear in the membrane that separates the middle ear from the inner ear. Air pressure is applied to each ear canal and the patient is monitored for abnormal eye movements or balance changes.
Audiometry (Hearing Test)
If you suffer from hearing loss or other hearing and balance related conditions, you may benefit from an audiologic evaluation. Hearing loss may be the result of trauma due to noise exposure, chronic ear infections, injury, underlying medical conditions, disease or other factors. These comprehensive diagnostic exams can determine the cause, severity and best treatment option for a condition resulting in hearing loss and/or a balance disorder.
Some of the common types of audiologic tests used for both children and adults include:
Diagnostic Audiogram -An audiogram uses sounds of specific frequencies and intensity levels to determine what a person can hear in each ear. The sounds are heard through headphones and the patient is asked to identify each time they hear a sound and in which ear. The sounds will become lower and lower in frequency to determine the level at which a patient is no longer hearing clearly. An audiogram may also include speech in the form of two-syllable words to determine how well a patient can comprehend what is being said. Normal results allow for a patient to hear a typical speaking voice, whisper and ticking of a watch.
Play Audiometry – Play audiometry is a modified version of the diagnostic audiogram, sometimes chosen instead when working with preschool and younger school-age children. The sounds are heard through headphones, but rather than raising a hand to indicate hearing a sound, the child places a toy in a container.
Tympanometry -Tympanometry examines and diagnoses the middle ear by varying air pressure in the ear canal to determine how the ear responds. A probe is inserted into the ear to change the air pressure, produce a tone and then measure the responses. The patient may not speak, move or swallow during the test because these actions can affect the ear pressure. Tympanometry measures the functionality of the ear drum or tympanic membrane. Abnormal results may be the result of fluid in the middle ear, a perforated ear drum or impacted ear wax.
Electrocochleography (ECoG) - This is a diagnostic procedure that measures electrical potentials within the inner ear by stimulating sounds. This procedure may be performed to determine if there is an excessive amount of fluid pressure on the inner ear, and is also effective in diagnosing Meniere's disease. During the ECoG procedure, several electrodes will be placed on the head, while a microphone and earphone will be placed inside the ear. A series of clicking noises will begin as the electrodes measure the body's natural response. This procedure can be performed in your doctor's office and generally takes about 40 minutes.
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