Referral & Testing information
We use established laboratory-based tests to evaluate inner ear involvement in the dizzy patient. When requested, ENT consultation following assessment can be arranged through our office. A recommendation for further management will be made whenever possible.
Test battery
Comprehensive Dizziness History
A comprehensive vestibular assessment begins with a detailed patient history: the single most valuable diagnostic tool available. Before any test is run, we take the time to understand the nature, timing, triggers, and trajectory of your patient's symptoms. The subsequent test battery is then selected and interpreted in that context, not in isolation. It's what makes the difference between a result and an answer.
Audiological Assessment
A diagnostic hearing test including middle ear and bone conduction testing is essential in evaluating the dizzy patient. Hearing and vestibular organs share the same structure — changes in hearing often corroborate or clarify vestibular findings.
Video Head Impulse Testing
An instrumented version of the bedside head impulse technique using sophisticated eye tracking and motion sensors. vHIT provides quantitative measurement of high-frequency semicircular canal function, compensation status, and site of lesion. Replaces or complements caloric testing for canal-specific assessment.
VNG Test Battery
Infrared video monitoring used to evaluate spontaneous and positional nystagmus, oculomotor function, and the caloric reflex in response to air irrigation. Caloric testing provides unilateral vestibular function data and remains a standard component of the comprehensive workup.
Vestibular Evoked Myogenic Potential Testing
Air or bone-conducted sound stimuli are used to assess otolith organ function.
- cVEMP — Surface electrodes on the ipsilateral SCM muscle assess saccular function via the inferior vestibular nerve.
- oVEMP — Surface electrodes beneath the contralateral eye assess utricular function via the superior vestibular nerve.
VEMP testing adds otolith-specific data not obtainable through canal-based tests alone.
Dix-Hallpike & Canalith Repositioning
The definitive diagnostic test for BPPV, rendered more sensitive with infrared video goggles. In cases of confirmed or suspected BPPV, canalith repositioning is performed with follow-up treatment as needed. Home exercise programs may be recommended where appropriate.
Auditory Brainstem Response & Electrocochleography
Electrophysiologic measurement of timing and amplitude of auditory neural activity in response to click or tone burst stimuli. ECOG places the recording electrode deep within the ear canal to maximize proximity to the cochlea. Contact the office to request these specialized tests.