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Balance
If you have been experiencing any form of dizziness, light-headedness or imbalance the consultant will probably require you to have some vestibular (balance) tests. None of the procedures are painful but may induce some degree of dizziness or light-headedness. Because of this we recommend that you bring a friend or relative with you but if you are on your own, you should rest in our waiting room until you feel well enough to leave.
Caloric Testing
Videonystagmography (VNG)
Posturography
Fistua Test VNG
Vestibular Evoked Myogenic Potentials (VEMP)
Hallpike Manoeuvre
Caloric Testing
You will be asked to refrain from taking any balance medication, as well as alcohol, for at least 48 hours before testing begins. You should not eat a heavy meal or anything too rich just before coming. Ladies should not wear heavy eye make-up as this interferes with the results.
This test can determine if you have a weakness in the balance portion of your inner ear that may be contributing to your symptoms. You will be required to lie on your back with your head at a 30° angle, to keep your eyes wide open and look straight ahead after each ear is filled with warm and cool water in turn. Your eye movements in response to the changes in temperature will be recorded. In between each irrigation you will be asked to close your eyes and rest for 4 minutes to give your eyes a chance to stabilise. You may experience some dizziness, but this is a normal reaction and should not last for more than a few minutes. There is also a slight chance that you may experience symptoms of nausea. This test may take up to 45 minutes depending on the results.
Videonystagmography (VNG)
You will be asked to refrain from taking any balance medication, as well as alcohol, for at 48 hours before testing begins. You should not eat a heavy meal or anything too rich just before coming. Ladies should not wear heavy eye make-up as this interferes with the results.
This test determines whether your balance problems are related to the brain (central) or the inner ear (peripheral). You will be required to wear set of goggles incorporating infrared-sensitive video cameras, which will record your eye movements while you sit in the dark following a little red light and keeping your head still. This test takes about 20 minutes.
Posturography
This is a measure of your overall balance. You will be required to wear a harness for safety and to stand on a platform without your shoes on with your hands at your sides. Different things will happen at different stages of the test, such as the platform moving slightly, but the vestibular scientist will warn you in advance and tell you exactly what to do. This test may take up to 30 minutes depending on the results.
Fistua Test VNG
This test will be performed if you have a history of giddiness, where erosion of the bony labyrinth (inner ear) is suspected perhaps due to infection, cholesteatoma or tumour. The vestibular scientist will alter the pressure in the ear canal either by pushing on the tragus (part of your outer ear) creating a repetitive pumping action or by using a pneumatic otoscope. The test is positive if you develop vertigo or nystagmus (jerky eye movements) which is monitored with the VNG goggles.
Vestibular Evoked Myogenic Potentials (VEMP)
The saccule is part of the sensory organs that primarily respond to movement but it also has a slight sensitivity to sound. This test determines if the pathway between this and the brainstem is intact and functioning normally.
Hallpike Manoeuvre
If you are suspected of having BPPV (benign paroxysmal positional vertigo = positional induced dizziness) this manoeuvre may be performed. You will be positioned sitting on a bed, keeping your eyes open and looking straight ahead. Your head will be held firmly by the examiner's hands and turned 45° to one side. You will then be rapidly laid backwards with your head over the bed. YOU WILL NOT BE ALLOWED TO FALL. You will be asked if this provokes your symptoms. If nothing happens within 30 seconds you will be returned to the upright position and asked if this has now provoked your symptoms. This process may be repeated on the other side.
ENT Diagnostics
Airway
Allergy
Balance
Hearing
Path
Smell
Voice
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