Balance & Vestibular Treatment

It is estimated that approximately 40% of the population in the United States will experience some form of dizziness or balance difficulty over the course of a lifetime (National Institute on Deafness and Other Communication Disorders [NIDCD], 2014).

Balance is maintained by the coordinated interactions between the brain, inner ears, eyes, as well as various muscles and joints. A disturbance in any of these areas may result in the subjective sensation of dizziness, lightheadedness, or unsteadiness. General medical ailments may also lead to dizziness due to interference with the brain and body’s ability to integrate balance information.

With such a wide range of balance disorders, it is important for an audiologist to make an accurate diagnosis in order to determine a successful treatment plan.  Diagnostic testing plays an important role in determining the condition responsible for a patient’s suffering. A battery of tests is usually required.

Types of Diagnostic Balance & Vestibular Tests

  • Videonystagmography (VNG). This series of tests measures eye movements via a pair of video goggles worn by the patient. A VNG consists of three parts: evaluation of eye movements as they follow a visual target, positional tests for measuring dizziness in response to different head and body positions, and a caloric test that measures responses to warm and cold air circulating in the ear canal.
  • Electrocochleography. This test is used to determine whether there is excess fluid in the inner ear by measuring the electrical currents generated by sound stimulation, and can help with the diagnosis of Meniere’s disease and other balance and hearing disorders.
  • Vestibular Evoked Myogenic Potential (VEMP).  VEMP testing is used to determine whether the saccule and utricle (inner ear organs) and the vestibular nerve is functioning properly. Electrodes are attached to the neck or under the eyes and sounds are transmitted through a pair of headphones.
  • Video Head Impulse Test (VHIT). This test is used to measure the eyes ability to maintain a steady gaze during head movements.  The patient wears video goggles that record the eyes during rapid head movements.
  • GANS Sensory Organization Performance Test. This test is a measure of a patient’s ability to maintain posture and balance in various conditions.
  • Rotational Chair Testing– This test includes different sub-tests, which are designed to help determine if your dizziness or imbalance is a result of a vestibular system or central nervous system problem.

These test results may be combined with additional diagnostic hearing tests to make an accurate diagnosis.