Overview

Our audiologists are also specialized in diagnosis of dizziness and balance disorders that affect millions of people. Dizziness can occur suddenly or gradually over a period of time. Working with patients who complain of dizziness is both challenging and rewarding because there are many causes for dizziness and balance problems. Patients can describe their symptoms in a hundred different ways. Because dizziness can be caused by several systems of the body, often a full test battery is necessary for an accurate diagnosis of the problem. Our facility offers a number of these tests. Below are some brief descriptions and pre-test instructions for each of them.

OTOACOUSTIC EMISSIONS

Otoacoustic Emissions are small sounds caused by motion of the eardrum in response to vibrations from deep within the cochlea. The healthy cochlea (inner ear) creates internal vibrations whenever it processes sound. Impaired cochleae usually do not. A mild acoustic stimulus, such as a click, tones, or noise are presented to the ear using an earphone and microphone combination probe fit into the ear canal.

There are no special instructions for an OAE test. The patient is asked to sit quietly with their eyes closed and relax in a dark sound treated room. For children, we can even run videos to keep them quiet, although the sound is kept off as to not affect the testing.

Otoacoustic emissions are one of the types of tests used in screening for hearing impairments in the newborn population. A more complete description is available under Newborn Hearing Screening.

If you have any questions regarding this information or about scheduling your appointment, please call our office at (703) 536-1666.

ELECTRONYSTAGMOGRAPHY

An ENG is a test of your balance mechanism. Certain types of medication will affect the ENG results and therefore, should not be taken at least 48 hours prior to the test date. A list of these medications is given below:

1. Sleeping pills
2. Tranquilizers
3. Antihistamines
4. Barbiturates
5. Alcoholic beverages
6. Anti-dizzy drugs
7. Sedatives
8. Muscle relaxants
9. Diuretics
10. If you are on other medications, please call to see if they should be stopped.

**DO NOT DISCONTINUE THE USE OF ANY PRESCRIBED MEDICATION WITHOUT FIRST CONSULTING YOUR PHYSICIAN**

It is also recommended that you do not eat, smoke or drink caffeinated beverages 3 to 4 hours before your test appointment.

The ENG evaluation is a procedure that requires approximately 1 to 1.5 hours to administer. Electrodes will be placed around your eyes to record their movement during the examination. The test is divided into three portions: The first section evaluates your ability to follow different types of visual "targets" with your eyes. The second section evaluates your eye movement behavior in response to changes in head and body position. In the third and final section, your ears will be irrigated with cool and warm water that may induce a sensation of movement. The records from these tests will be used to determine the integrity of the inner ear balance system.

Do not wear any makeup. Casual, comfortable clothing is recommended. Contact lenses should not be worn.

If you have any questions regarding this information or about scheduling your appointment, please call our office at (703) 536-1666.

AUDITORYBRAINSTEM RESPONSE (ABR)

An AUDITORY BRAINSTEM RESPONSE (ABR) is an examination that can only be ordered by your physician. This is one of many tests that may be recommended for the evaluation of dizziness, balance problems, hearing loss, ear pressure and/or ear noises (tinnitus). The ABR test allows us to determine how well electrical impulses are generated by the inner ear and travel to the brainstem. Specifically the test helps to determine whether or not there is a blockage in the transmission of electrical signals to the brain. A small percentage of patients may have benign growths on the nerve leading from the ear to the brain (acoustic neuroma). This test can help determine if such a benign growth is present or if your symptoms are due to other causes.

The ABR test is administered by placing electrodes in your ear canal or on your earlobes and on your head and forehead. Sounds called acoustic clicks are presented to each ear individually. The electrodes are used to pick up the electrical responses of the ear to the sounds as they travel from the ear through the nerve and up into the brainstem. The test is similar to a brain wave test (EEG) except that you hear the acoustic clicks during the examination. The procedure is painless and you may sleep during the examination. It usually takes about 45 minutes to apply the four electrodes and perform the test.

Please remember that proper identification of the cause of your symptoms is important in order for your physician to determine the best course of medical treatment. This test has been ordered in your best interest and should be performed as soon as possible.

Casual, comfortable clothing is recommended and patients are advised to wear slacks. There are no other special instructions for this examination and you may resume your normal activities immediately following the examination. 

If you have any questions regarding this information or about scheduling your appointment, please call our office at (703) 536-1666.

ELECTROCOCHLEOGRAPHY

An ECOG is a test that helps determine whether or not there is an abnormal increase in fluid pressure in the inner ear. The test helps to rule out various conditions of the inner ear such as Meniere’s disease.

The ELECTROCOCHLEOGRAPHY examination is administered by placing electrodes in your ear canal and on your forehead. Sounds called acoustic clicks are presented to each ear individually. The ear generates electrical activity in response to the acoustic clicks which are picked up by the electrodes and analyzed by the computer. We evaluate these recordings to determine how the inner ear and hearing nerve (VIII cranial nerve) are functioning. The examination generally takes about 45 minutes and does not require any special preparation. You may resume your normal activities immediately following the examination.

Please remember that this is one of the only tests that can verify an abnormal build-up of fluid in your inner ear. Proper identification of the cause of your symptoms is important for your physician to determine the best form of medical treatment.

If you have any questions regarding this information or about scheduling your appointment, please call our office at (703) 536-1666.

VESTIBULAR EVOKED MYOGENIC POTENTIALS (VEMP)

The VEMP test measures the vestibular evoked myogenic potential generated by a loud stimulus in the ipsilateral ear. It is used in balance testing to evaluate saccule function and the integrity of the inferior vestibular nerve.

The VEMP examination is non-invasive. It is administered by placing electrodes on the patient's neck, forehead, and sternum, as well as placing insert ear phones or head phones in/on the patient's ears. Sounds called acoustic clicks are presented to each ear individually. During the examination the patient will be seated in a chair and asked to turn there head in a certain orientation to allow for the tightening of the sternocleidoid muscle. The examination generally takes about 45 minutes and does not require any special preparation. Please remember that proper identification of the cause of your symptoms is important in order for your physician to determine the best course of medical treatment. This test has been ordered in your best interest and should be performed as soon as possible. Casual, comfortable clothing is recommended and patients are advised to wear slacks. You may resume your normal activities immediately following the examination.

If you have any questions regarding this information or about scheduling your appointment, please call our office at (703) 536-1666.

COCHLEAR HYDROPS ANALYSIS MASKING PROCEDURE (CHAMP)

The CHAMP test measures latency changes of wave V when a broad band click stimulus in the ipsilateral ear is presented. It is used to identify a condition called cochlear hydrops.

The CHAMP examination is non-invasive. It is administered by placing electrodes on the patient's mastoids or ear lobes and on top of the head, as well as placing insert ear phones into the patient's ears. Sounds called acoustic clicks are presented to each ear. During the examination the patient will be seated in a reclining chair and asked to remain still and relaxed. At this time taking a nap is possible. The examination generally takes about 45 minutes and does not require any special preparation. Please remember that proper identification of the cause of your symptoms is important in order for your physician to determine the best course of medical treatment. This test has been ordered in your best interest and should be performed as soon as possible. Casual, comfortable clothing is recommended and patients are advised to wear slacks. You may resume your normal activities immediately following the examination.

If you have any questions regarding this information or about scheduling your appointment, please call our office at (703) 536-1666.

DYNAMIC POSTUROGRAPHY TESTING (EquiTest)

Dynamic Posturography is designed to better assess your particular balance problem. It is simply a test of your ability to maintain balance. You will be asked to stand quietly on a platform facing into a surrounding curtain with a picturesque view. During the test you will be asked to open or close your eyes for brief periods of time. While you do so, the platform and/or the visual surround may or may not move. Your body will automatically respond to each test to maintain your balance. Should you lose your balance, a harness will prevent you from falling. Your test responses will be automatically recorded for later analysis and reviewed by the audiologist and your doctor.

The EQUITEST battery consists of three portions: the MOVEMENT COORDINATION and the SENSORY ORGANIZATION portions will be requested for most patients. In addition, some physicians may request the PRESSURE TEST. All of the tests are painless and each portion takes approximately 15-20 minutes to administer.

You may experience minor feelings of dizziness or imbalance during some of the test. In a clinical environment, these symptoms provide your doctor with valuable information about your condition.

The test can help you as a patient by first, assisting your doctor in learning more about the cause of your dizziness or imbalance. The test examines your ability to use the senses of balance – your eyes, inner ear, and your feet and muscles. It also assesses your ability to perform effective movements to regain your balance. Second, the results of the test can help your doctor determine the best course of treatment. It can also identify those environments in which you may be at risk of falling, and help you to learn techniques to prevent falls.

If you have any questions regarding this information or about scheduling your appointment, please call our office at (703) 536-1666.

TEST PREPARATION

Certain types of medication will affect the EQUITEST results, and therefore should not be taken with 48 hours prior to the test date. A list of these medications is listed below.

1. Sleeping pills
2. Tranquilizers
3. Antihistamines
4. Barbiturates
5. Alcoholic beverages
6. Anti-dizzy drugs
7. Sedatives
8. Muscle relaxants
9. Diuretics
10. If you are on other medications, please call to see if they should be stopped.

**DO NOT DISCONTINUE THE USE OF ANY PRESCRIBED MEDICATION WITHOUT FIRST CONSULTING YOUR PHYSICIAN**

It is also recommended that you do not eat, smoke or drink caffeinated beverages 3 to 4 hours before your test appointment. Casual comfortable clothing is recommended and patients are advised to wear slacks.

If you have any questions regarding this information or about scheduling your appointment, please call our office at (703) 536-1666.

VESTIBULAR AUTOROTATION TEST (VAT)

The Vestibular Autorotation Test (VAT) is a computerized test based on 18 seconds of active head movements to evaluate both the high frequency horizontal and vertical vestibulo-ocular reflex (VOR) systems. The VOR oculomotor control system stabilizes fixation of the eyes during head rotation by causing the eyes to move in the opposite direction of the head motion. It stabilizes vision by preventing images from moving across the retina. The main purpose of the VOR is to allow clear vision during movement by sending signals to move the eye muscles to compensate for the small rapid head movements that occur in everyday life. However if the speed or timing is off, even slightly, vision is distorted because of apparent movement of the visual fields. The VAT tests the normal, everyday range of motion (2-6Hz) where many balance disorders occur, by comparing eye movement to head motion. Electrodes record eye movement and a rotational velocity head sensor records head movement. The VAT can be used in diagnosis and also monitoring changes during vestibular rehabilitation.

The VAT is comfortable and easy to perform. You are asked to look at the target and move your head to the computer-generated tone. The tone begins slowly and becomes increasingly faster over the 18-second period.

Certain types of medication will affect the results, and therefore should not be taken with 48 hours prior to the test date. A list of these medications is listed below.

1. Sleeping pills
2. Tranquilizers
3. Antihistamines
4. Barbiturates
5. Alcoholic beverages
6. Anti-dizzy drugs
7. Sedatives
8. Muscle relaxants
9. Diuretics
10. If you are on other medications, please call to see if they should be stopped.

**DO NOT DISCONTINUE THE USE OF ANY PRESCRIBED MEDICATION WITHOUT FIRST CONSULTING YOUR PHYSICIAN**

Casual comfortable clothing is recommended and patients are advised to wear slacks.

If you have any questions regarding this information or about scheduling your appointment, please call our office at (703) 536-1666.