The main purpose is to assess the balance function of the patient. Some diagnostic information may be obtained regarding central/visual disorders and peripheral function. Some (but not all) patients may be appropriate for Vestibular Rehabilitation.
Assessment is lead by an Audiologist / Clinical Scientist with the appropriate BAA CAC/HTS competency. Appointments are 105 minutes (full assessment) or 60 minutes (partial assessment) and may include initial vestibular rehabilitation if appropriate. Appointments will be sent with an accompanying Information Sheet.
If appropriate Pure Tone Audiometry will be performed and Otoscopy / Tympanometry to confirm that the tympanic membranes are intact prior to caloric investigation. Significant wax occlusion may preclude a successive caloric irrigation.
The procedure will be explained to the patient in an appropriate manner, who will have received a Patient Information sheet with their appointment. An Audiovestibular History will be taken by the Clinical Scientist, including patient problems relating to their balance or dizziness.
Questionnaire measures including Vestibular Rehabilitation Benefit Questionnaire, HADS and Nijmegen may be used.
Vestibular assessment is performed using a Balance Master Static Posturography, Synapsis Videonystagmography (VNG) system and Caloric Irrigation system. Tests will usually be performed in the following order:-
- Clinical Balance Assessment (may include Romberg, Unterberger, Timed Getup and Go, Dynamic Gait Index)
- Static Posturography (to assess vestibular, visual and proprioceptive inputs)
- Videonystagmography (may include Horizonatal Saccade assessment, Spontaneous Nystagmus, Smooth Pursuit). These tests are useful for obtaining an objective assessment of the visual system and for signs which may be consistent with a central disorder.
- Positional Nystagmus, including Dix-Hallpike and Neck Positional testing. These tests are useful if there appears to be a positional element to the reported symptoms, and also to investigate clinical findings consistent with Benign Paroxysmal Positional Vertigo (BPPV).
- Head Shake / Head Thrust (if appropriate)
- Caloric Investigation (bithermal water or air – to evaluate the function of the lateral semicircular canals and is useful in detecting hypofunction and asymmetry in function)
Results and Further Management
The Clinical Scientist will produce a report and forward it to the referring consultant within 5 working days.
Lynzee McShea – Senior Clinical Scientist (Audiology)
0191 569 9001