Taking vestibular testing outside of the clinic: Part II

05 February 2024

In June 2023, with the support of the William Demant Foundation, Dr. Daniel Romero and audiology students from Vanderbilt University Medical Center (VUMC) embarked on a mission trip to Kraków, Poland to provide hearing and vestibular services to Ukrainian refugees.

Read more: Taking vestibular testing outside of the clinic

In November 2023, the group completed a second visit to provide services to a new group of refugees with primary complaints of dizziness and imbalance. The team also utilized this trip to follow up with patients originally evaluated in June.

 

Aspen Bombardo (student) performing ocular motility at bedside on a patient under video goggles. This testing was used to determine if patients showed signs of a central oculomotor impairment.

 

Given that most patients tested this time around reported active symptoms of dizziness and/or imbalance, the team wanted to improve the vestibular testing protocol as well as make improvements to the patient handouts with the assistance of a physical therapist and collaborator, Dr. Holly Cauthen, PT, DPT.

The team was able to bring the portable EyeSeeCam vHIT system with the assistance of Interacoustics.

 

Lateral head thrusts were used to assess high-frequency (speed) VOR function on patients experiencing dizziness and imbalance.

 

The inclusion of vHIT was ideal since it allowed more objective assessment of peripheral vestibular impairment and could be used in conjunction with the VisualEyes™ video goggles and software the team used in prior assessment. In addition to improvements to the testing protocol, the team also incorporated goal-oriented therapy to make handing out vestibular exercises simple, yet challenging and easy to follow to ensure patient understanding.

 

Elizabeth Grossman (student) instructing and demonstrating VORx1 gaze stabilization exercises for a patient diagnosed with an uncompensated peripheral vestibular impairment affecting the VOR.

 

In the November trip, the team assessed 35 patients with a mean age of 60 years (SD = 12.6 years; 33 female). See overall findings of suspected cases in Table 1.

 

Vestibular impairment Percentage of patients
Imbalance 40%
Peripheral vestibular impairment 29%
Vestibular migraine 26%
Central involvement 23%
BPPV 11%
Unspecified 9%
PPPD 3%

Table 1: Vestibular impairments identified in the 35 patients.

 

Furthermore, they were able to follow up with patients tested in June. Most patients reported improvement in their symptoms while other still reported dizziness. In anticipation of this, the team provided more challenging exercises to increase the success of vestibular compensation. Further follow ups with these patients are expected to take place over the next few months.

 

Aspen Bombardo (student) and Elizabeth Grossman (student) teaming up to perform Dix-Hallpike testing on a patient experiencing dizziness.

 

Overall, there is strong evidence for a need of vestibular testing for those who currently do not have access to it including other international and domestic communities. While currently an incomplete vestibular evaluation, this trip helps support that testing is possible and feasible.

 

Students calibrating EyeSeeCam vHIT goggles to assess high-frequency (speed) VOR function.

 

About the authors

Dr. Daniel Romero, Au.D., Ph.D., is a Postdoctoral Research Fellow at Vanderbilt University Medical Center (VUMC). He earned his Au.D. in 2018 from Northern Illinois University after which he took his Ph.D. at James Madison University.

Dr. Liz Fuemmeler, Au.D., is a Clinical Product Manager with Interacoustics and Vestibular Program Director at Professional Hearing Center in Kansas City, MO.

Dr. Daniel Romero, Au.D., Ph.D.
Reviewed by Liz Fuemmeler, Au.D.

Published: 05 February 2024
Modified: 06 February 2024

Subscribe

By signing up, I accept to receive newsletter e-mails from Interacoustics. I can withdraw my consent at any time by using the ‘unsubscribe’-function included in each e-mail.

Click here and read our privacy notice, if you want to know more about how we treat and protect your personal data.


Follow Us

Similar Topic

Get audiological tips

Subscribe for audiological tips and be the first to know about new products, features and training.

By signing up, I accept to receive newsletter e-mails from Interacoustics. I can withdraw my consent at any time by using the ‘unsubscribe’-function included in each e-mail.

Click here and read our privacy notice, if you want to know more about how we treat and protect your personal data.

Interacoustics - hearing and balance diagnosis and rehabilitation
Copyright © Interacoustics A/S. All rights reserved.