best practices vng testing

best practices vng testing - ASHA 2008 Page 1 Best...

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ASHA 2008 Page 1 Best Practices in Administering VNG/ENG Kamran Barin, Ph.D. Balance Disorders Clinic The Ohio State University 456 W. 10th Ave., Room 4024 Columbus, OH 43210 Phone: (614) 293-8067 email: barin.1@osu.edu Best Practices in Administering VNG/ENG - Agenda Best practices in administering and analyzing the caloric test Best practices in administering the Dix-Hallpike maneuver Best practices in administering the static position test Best practices in administering the oculomotor tests BEST PRACTICES IN CALORIC TESTING
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ASHA 2008 Page 2 Caloric Test - Standards American National Standards Institute (ANSI) - Procedures for testing basic vestibular function, (1999). British Society of Audiology (BSA) - Caloric test protocol, (1999). British Journal of Audiology . vol. 33, no. 3, pp. 179-84. Committee on Hearing, Bioacoustics, and Biomechanics (CHABA) - Evaluation of tests for vestibular function, (1992). Aviation, Space, and Environmental Medicine, vol. 63, no. 2, Suppl, pp. A1-34. Caloric Test – ANSI/BSA Standards Calibrate before each irrigation Test sequence- RW, LW, RC, LC Recordings with eyes open in the dark 5 minutes between start of consecutive irrigations ANSI - Use water or closed loop (no air) – Water: 200 ml/min, 40 sec., 44° warm, 30° cool – Closed loop: 350 ml/min, 40 sec., 44° warm, 27° cool BSA - Use water or air (no closed loop) – Water: 250 ml/min, 30 sec., 44° warm, 30° cool – Air: 8 liters, 60 sec., 50° warm, 24° cool Caloric Test – Calibration ANSI/BSA recommendation based on non- computerized/strip chart recording – Calibration is verified with minor adjustment when necessary In computerized ENG and VNG, recalibrations can vary by as much as 17% from one calibration to another Recommended procedure: – In computerized ENG and VNG, do not recalibrate before each procedure – Instead, verify calibration (using mock saccade or tracking test) and recalibrate only if necessary
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ASHA 2008 Page 3 Caloric Test – Order of Irrigations ANSI/BSA recommendation based on a study that shows in ENG, caloric response intensity declines with each irrigation – To avoid systematic bias, either irrigation order must be adjusted or formulas must include a correction factor VNG recordings show this effect is limited to ENG Recommended procedure: – Start with one temperature and irrigate ears in the same order for each temperature – Verify calibration between irrigations (mainly in ENG) – ANSI/BSA-recommended order follows these guidelines and can be followed to maintain consistency Caloric Test – Test in Total Darkness With Eyes Open ANSI/BSA recommendation based on a study that shows better nystagmus morphology in total darkness with eyes open compared to eyes closed – Only an issue in ENG – Difficult to maintain a completely dark lab environment
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This note was uploaded on 04/11/2010 for the course AUD 831 taught by Professor Drlisakoch during the Spring '10 term at A.T. Still University.

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best practices vng testing - ASHA 2008 Page 1 Best...

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