Assessing Vestibular Function in Patients with Stickler Syndrome using vhit.
|
|
- Eileen Ward
- 5 years ago
- Views:
Transcription
1 Assessing Vestibular Function in Patients with Stickler Syndrome using vhit. Keiran Joseph Dr David Baguley Dr Kai Uus Addenbrooke s Hospital I Rosie Hospital
2 Learning Outcomes What is Stickler Syndrome? Why should we be interested in vestibular function in Stickler syndrome? What is the functionality of the peripheral vestibular system in Stickler syndrome?
3 Background Stickler Syndrome Stickler syndrome is a genetic disorder impairing the synthesis of collagen throughout the body thought to effect 1/7,500 1/9,000 newborns (Robin et al, 1993). First described by Stickler et al. (1965) Stickler syndrome is characterised by Ocular, Skeletal and Orofacial abnormalities. Gunner Stickler and a Giant Retinal Tear courtesy of Wendy Hughes, President of Stickler Syndrome Society
4 Genetics Currently mutations in 5 genes are known to cause Stickler syndrome and thus 5 distinct types exist. Mutation Prevalence Inheritance COL2A1 (Type 1) 80-90% Dominant COL11A1 (Type 2) 10-20% Dominant COL11A2 (Type 3) Rare Dominant COL9A1 (Type 4) Rare Recessive COL9A2 (Type 5) Rare Recessive
5 Audiological Involvement Audiometry Hearing loss affects 63% of people with Sticklers syndrome and is thought to be attributable to collagen deficiencies throughout the inner ear, middle ear and tympanic membrane (Khetarpal et al, 1994; McGuirt et al, 1999; Stenfeldt et al, 2006; Knutsson et al, 2009), Acke et al, 2012).. The prevalence of hearing loss varies between types but can be mixed, sensorineural or conductive.
6 Audiological involvement Tympanometry Hyper-compliant tympanograms are identified in up to 46% of Stickers as their tympanic membranes lack structural collagen (Acke et al, 2012). This lack of collagen is also responsible for greater risk of longstanding perforation.
7 But what do we know about the vestibular system?
8 So should vestibular function be an issue? Collagen is present throughout the vestibular system in the Macula, the SSC membrane, the Ampulla and the Endolymphatic duct (Ishibe et al. 1989; Slepecky et al. 2009; Yoo and Tomoda, 1988). Complaints of imbalance are common but often attributed to skeletal or ocular abnormalities and have rarely been investigated further (Acke et al, 2012). Peripheral vestibular dysfunction has been demonstrated in the phenotypically very similar Marshall Syndrome (Griffith et al, 2000; Griffith et al, 1998).
9 Current understanding
10 Scoping Exercise Bespoke questionnaire distributed to the UK and US Stickler societies as a scoping exercise. 69 patients responded; some interesting figures: Occurring Monthly or more: 40% spontaneously have a spinning sensation 66% have a spinning sensation with head movement Of those who are dizzy, 64% said it interferes with their work, social or recreational life at least some of the time
11 Scoping Exercise: Quotes Turning head quickly as in changing lanes in traffic, getting out of bed some mornings or in the middle of night I have to sit quietly on the edge of bed until it gets better Sudden movements of any kind does it very easily One episode was frightening - when I opened my eyes everything was spinning at a very fast velocity
12 How do we assess Vestibular function? Bi-thermal caloric irrigation is the current gold standard in assessing peripheral vestibular function but are frequently contraindicated in Stickler patients because of the tympanic membrane abnormalities. Rotatory chair testing could have been possible but I do not have access to the equipment. VEMPs could also have been an option but as a number of Stickler patients have a conductive element to their hearing loss these would have been unfeasible in the majority of cases.
13 Slide courtesy of Matthew Murray (GN Otometrics)
14 Assessment of Vestibular function - vhit The video head impulse test measures the vestibuloocular reflex by tracking pupil movement relative to head movement and can be carried out in all 6 vestibular canals. The results are then analysed and the gain displayed for interpretation. Special thanks to GN Otometrics for loaning the equipment and the images.
15 Assessment - Other A concise clinical history to identify main (if any) vestibular complaints and to check for contraindications. Audiometry and tympanometry were carried out to assess for correlations with hearing loss DHI to assess any correlation between impaired vestibular function and resultant dizziness handicap.
16 Design and Procedure Ethical approval was given by Cambridge Central REC. Stickler patients attend an annual Ophthalmology review at Addenbrookes. All of those fitting the inclusion criteria with Ophthalmology appointments during the data collection were invited to participate. I have tested 17 participants to date. 8 Male, 9 Female 10 Type 1, 7 Type 2 Median age 45, Range 27-71
17 Research Questions 1. What is the incidence of abnormal peripheral vestibular function in Stickler syndrome? 2. Is there a difference in the incidence of abnormal peripheral vestibular function between the different types (gene mutations)? 3. Is the incidence of abnormal peripheral vestibular function related to hearing loss?
18 Provisional vhit and DHI results Of the 17 tested only 1 has had an abnormal vhit result. 38 Y/O female with type 1 Stickler syndrome Has had bouts of TRV in the past with an ear infection Gain of 0.65 (>0.7 is normal) in the right anterior SSC 1 Unable to complete testing because of severe Ptosis vhit was normal in the remaining 15 participants but 5 scored significant on DHI. 2 were type 1 and 3 were type 2, when combined with the vhit results, no clear genotypic susceptibility is highlighted.
19 vhit Display of Significant patient (P2) Covert Saccades
20 Provisional Audiometry results Audiometry (FFA >20dB = Hearing loss) 3 Normal Hearing 1 Unilateral SNHL 3 Mixed one sided and SNHL the other - 1 Abnormal 4 Bilateral SNHL 2 Abnormal 1 Bilateral CHL Abnormal 4 Bilateral Mixed - 2 Abnormal
21 Provisional Tympanometry results Tympanometry 7 Normal Tympanometry 3 Abnormal 3 Hyper-complaint (>3cm 3 ) -1 Abnormal 1 Perforation 1 Flat Abnormal 5 Negative beyond -150daPa 1 Abnormal Trends: 10/17 contraindicated for calorics No obvious trend with Tympanometry and predicting abnormal vhit or significant dizziness handicap.
22 Summary Only 1/ 17 demonstrated reduced gain on vhit but a further 5 showed a handicap on the DHI. No obvious trend for one genotype to be more susceptible emerged All of those with reduced gain or significant DHI had a hearing loss. 10/17 were contraindicated for calorics based on tympanometry alone.
23 Why the Mismatch? Though vhit results are mainly normal, some histories suggest peripheral vestibular involvement: Why the Mismatch? vhit testing is not sensitive enough. Perhaps vhit is not the complete test. The dizziness may not be vestibular at all.
24 Learning outcomes Reviewed What is Stickler Syndrome? Why should we be interested in vestibular function in Stickler syndrome? What is the functionality of the peripheral vestibular system in Stickler syndrome?
25 Acknowledgements Mr Martin Snead and team (Cambridge University Hospital) Matthew Murray and David Smithson (GN Otometrics) Dr David Baguley (Cambridge University Hospital) Dr Kai Uus (University of Manchester)
Patient: A 65-year-old male who is a Medicare Part B beneficiary, whose testing was ordered by his internist
The following examples are to assist you with PQRS reporting. These examples were created in collaboration with the Academy of Doctors of Audiology and the American Speech-Language-Hearing Association
More informationVIDEONYSTAGMOGRAPHY (VNG)
VIDEONYSTAGMOGRAPHY (VNG) Expected outcomes Site of lesion localization: Determine which sensory input, motor output, and/ or neural pathways may be responsible for reported symptoms. Functional ability:
More informationSasan Dabiri, MD, Assistant Professor
Sasan Dabiri, MD, Assistant Professor Department of Otorhinolaryngology Head & Neck Surgery Amir A lam hospital Tehran University of Medical Sciences October 2015 Outlines Anatomy of Vestibular System
More informationVideo Head Impulse Testing
Authored by: David J. Coffin, Au.D. e3 Gordon Stowe Chicago Chicago, Illinois The video Head Impulse Test (vhit) is a relatively new test that provides diagnostic and functional information about the vestibular
More informationWhy Pediatric Hearing Clinic
Why Pediatric Hearing Clinic RICHARD KANG, M.D., ASHLEY KAUFMAN, AU.D. AND MALLORY AUCH, RN Our Staff: Mallory Auch, RN Nurse Coordinator Kristen Janky, PhD, AuD, CCC-A Vestibular Audiologist Richard Kang,
More informationPaediatric Balance Assessment
BAA regional meeting 11 th March 2016 Paediatric Balance Assessment Samantha Lear, Lead Clinical Scientist, Hearing Services, SCH overview The balance system Vestibular disorders referrals Vestibular assessment
More informationINCIDENCE OF SUSPECTED OTOLITHIC ABNORMALITIES IN MILD TRAUMATIC BRAIN INJURED VETERANS OBSERVATIONS FROM A LARGE VA POLYTRAUMA NETWORK SITE
INCIDENCE OF SUSPECTED OTOLITHIC ABNORMALITIES IN MILD TRAUMATIC BRAIN INJURED VETERANS OBSERVATIONS FROM A LARGE VA POLYTRAUMA NETWORK SITE David Domoracki Ph.D. Cleveland VAMC Audiology Service Jennifer
More informationCITY & HACKNEY PATHFINDER CLINICAL COMMISSIONING GROUP. Vertigo. (1) Vertigo. (4) Provisional Diagnosis. (5) Investigations. lasting days or weeks
Authors: Dr Lucy O'Rouke and Mr N Eynon-Lewis Review date: January 2017 Vertigo (1) Vertigo (2) History (3) Examination (4) Provisional Diagnosis (5) Investigations (6) Medical Cause (7) Psychiatric Cause
More informationTEMPLATES FOR COMPREHENSIVE BALANCE EVALUATION REPORTS. David Domoracki PhD Cleveland Louis Stokes VA Medical Center
TEMPLATES FOR COMPREHENSIVE BALANCE EVALUATION REPORTS David Domoracki PhD Cleveland Louis Stokes VA Medical Center The following templates are in outline form. I designed them so that the IRM local network
More informationVIDEONYSTAGMOGRAPHY (VNG) TUTORIAL
VIDEONYSTAGMOGRAPHY (VNG) TUTORIAL Expected Outcomes Site of lesion localization: Determine which sensory input, motor output, and/or neural pathways may be responsible for the patient s reported symptoms
More informationVESTIBULAR LABYRINTHS comprising of 3 semicircular canals, saccule, utricle VESTIBULAR NERVE with the sup. & inf. vestibular nerves VESTIBULAR
VESTIBULAR LABYRINTHS comprising of 3 semicircular canals, saccule, utricle VESTIBULAR NERVE with the sup. & inf. vestibular nerves VESTIBULAR NUCLEUS BRAINSTEM CEREBELLUM VESTIBULAR CORTEX EYES SPINAL
More informationVestibular service (balance)
The vestibular service at Addenbrooke s Hospital works closely with the Ear Nose and Throat (ENT), Neurology consultants and physiotherapists to help manage patients with dizziness/balance problems. The
More informationCoding with Confidence:
Coding with Confidence: CPT, HCPCS, Modifiers & ICD-10 Alyssa Needleman, PhD Nova Southeastern University August 4, 2017 Coding Considerations: Procedure (CPT, HCPCs) and Diagnosis (ICD-10) Code for test/procedure(s)
More informationManagement of Ear, Hearing and Balance Disorders: Fact, Fiction, and Future
Management of Ear, Hearing and Balance Disorders: Fact, Fiction, and Future George W. Hicks, M,D. 7440 N. Shadeland Avenue, Suite 150 Indianapolis, IN 46250 904 N. Samuel Moore Parkway Mooresville, IN
More informationInformation packet regarding hearing and balance testing at Chicago Dizziness & Hearing
CHICAGO DIZZINESS AND HEARING 645 N. Michigan Ave, Suite 410, Chicago, IL 60611 www.dizzy-doc.com Timothy C. Hain, M.D. Ph: (312)274-0197 Fax: (312)376-8707 Marcello Cherchi, M.D., Ph.D. Email: reception@dizzy-doc.com
More informationDisclosures. Vestibular Loss in the Pediatric Population: Does vestibular loss. affect more than balance? Learner Objective. Outline 12/15/2015
Vestibular Loss in the Pediatric Population: Does vestibular loss affect more than Kristen Janky, Ph.D. Disclosures Employed by Boys Town National Research Hospital Consulting for Otometrics Received Speaker
More informationAudiologic and Genetic Determination of Hearing Loss in Osteogenesis Imperfecta
Ghent University Hospital Ghent University Audiologic and Genetic Determination of Hearing Loss in Osteogenesis Imperfecta Swinnen F 1, De Leenheer E 1, Coucke P 2, Cremers C 3, Dhooge I 1 1 Department
More informationHearing loss and fluctuating hearing levels in X-linked hypophosphataemic osteomalacia
The Journal of Laryngology & Otology (2009), 123, 136 140. # 2008 JLO (1984) Limited doi:10.1017/s0022215107001636 Clinical Record Hearing loss and fluctuating hearing levels in X-linked hypophosphataemic
More informationHEARING IMPAIRMENT LEARNING OBJECTIVES: Divisions of the Ear. Inner Ear. The inner ear consists of: Cochlea Vestibular
HEARING IMPAIRMENT LEARNING OBJECTIVES: STUDENTS SHOULD BE ABLE TO: Recognize the clinical manifestation and to be able to request appropriate investigations Interpret lab investigations for basic management.
More informationICS Impulse: Bringing diagnostic accuracy and efficiency into balance testing
Greater precision...faster diagnosis The head impulse test (HT) provides quick, clear-cut side of lesion specific assessment of the vestibulo-ocular reflex response to stimuli in the high-frequency range,
More informationClinical Policy Title: Video head impulse testing
Clinical Policy Title: Video head impulse testing Clinical Policy Number: 09.01.16 Effective Date: March 1, 2018 Initial Review Date: January 11, 2018 Most Recent Review Date: February 6, 2018 Next Review
More informationWindow to an Unusual Vestibular Disorder By Mark Parker
WELCOME BACK to an ongoing series that challenges the audiologist to identify a diagnosis for a case study based on a listing and explanation of the nonaudiology and audiology test battery. It is important
More informationSECTION 6: DIAGNOSTIC CLASSIFICATION TERMS AND NORMATIVE DATA
SECTION 6: DIAGNOSTIC CLASSIFICATION TERMS AND NORMATIVE DATA Revision: 8-17-2016 92 Diagnostic Classification Terms and Normative Data Classification of magnitude of hearing loss Normal 0 15 db HL Borderline
More informationMonitoring of Caloric Response and Outcome in Patients With Benign Paroxysmal Positional Vertigo
Otology & Neurotology 28:798Y800 Ó 2007, Otology & Neurotology, Inc. Monitoring of Caloric Response and Outcome in Patients With Benign Paroxysmal Positional Vertigo *Maria I. Molina, *Jose A. López-Escámez,
More informationOfficial CPT Description
s CPT 69209 Removal of impacted cerumen using irrigation/lavage, unilateral 69210 Removal impacted cerumen using instrumentation, unilateral 92516 Facial nerve function studies (eg, electroneurography)
More information2013/14 NHS STANDARD CONTRACT FOR STICKLER SYNDROME DIAGNOSTIC SERVICE (CHILDREN) D12/S(HSS)/d. Stickler syndrome diagnostic service(children)
D12/S(HSS)/d 2013/14 NHS STANDARD CONTRACT FOR STICKLER SYNDROME DIAGNOSTIC SERVICE (CHILDREN) SECTION B PART 1 - SERVICE SPECIFICATIONS Service Specification No. Service Commissioner Lead Provider Lead
More informationUsher Syndrome: When to Suspect it and How to Find It
Usher Syndrome: When to Suspect it and How to Find It Margaret Kenna, MD, MPH Katherine Lafferty, MS, CGC Heidi Rehm, PhD Anne Fulton, MD Harvard Medical School Harvard Medical School Center for Hereditary
More informationAn Introduction to Hearing Loss: Examining Conductive & Sensorineural Loss
Sacred Heart University DigitalCommons@SHU Speech-Language Pathology Faculty Publications Speech-Language Pathology Spring 2017 An Introduction to Hearing Loss: Examining Conductive & Sensorineural Loss
More informationDraft Guidelines for the Onward Referral of Adults with Hearing Loss Directly Referred to Audiology Services (2016)
Draft Guidelines for the Onward Referral of Adults with Hearing Loss Directly Referred to Audiology Services (2016) Produced by: Service Quality Committee of the British Academy of Audiology Key Authors:
More informationVestibular Learning Manual: Interview with Bre Lynn Myers, AuD
Print Email Vestibular Learning Manual: Interview with Bre Lynn Myers, AuD Douglas L. Beck, AuD, speaks with private practice co-owner and author, Bre Myers, about her new book that includes topics such
More informationUniversity of Groningen. Definition Menière Groningen Mateijsen, Dionisius Jozef Maria
University of Groningen Definition Menière Groningen Mateijsen, Dionisius Jozef Maria IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please
More information7. Anatomy and physiology of the vestibular system. Harmonic and disharmonic vestibular syndrome.
7. Anatomy and physiology of the vestibular system. Harmonic and disharmonic vestibular syndrome. 8. Fundamental examination tools of otoneurology. 20. Ménière s syndrome and Ménière s disease. Therapeutic
More informationStickler syndrome. Geert Mortier, MD, PhD Center for Medical Genetics Ghent University Hospital Ghent, Belgium
Stickler syndrome Geert Mortier, MD, PhD Center for Medical Genetics Ghent University Hospital Ghent, Belgium Third European Course in Clinical Dysmorphology Rome, November 20-21, 2009 Stickler syndrome
More informationPeripheral vestibular disorders will affect 1 of 13 people in their lifetime
Peripheral vestibular disorders will affect 1 of 13 people in their lifetime 80% of affected persons seek medical consultation Unclear how many of these are for peripheral vs central disorders Generally:
More informationVestibular testing: what patients can expect
American Hearing Research Foundation Symposium on Dizziness & Balance Disorders April 6, 2013 Vestibular testing: what patients can expect Marcello Cherchi, MD PhD Assistant Professor of Neurology Northwestern
More informationDoctor of Audiology Post-Professional Program. Online Education for Practicing Audiologists. AuD. Curriculum Guide
Doctor of Audiology Post-Professional Program Online Education for Practicing Audiologists AuD Curriculum Guide Doctor of Audiology Post-Professional Program Curriculum Guide Course Descriptions Courses
More informationCorporate Medical Policy
Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: vestibular_function_testing 5/2017 N/A 10/2017 5/2017 Description of Procedure or Service Dizziness, vertigo,
More informationlatest development in advanced testing the vestibular function
latest development in advanced testing the vestibular function how to explore the vestibular function in detail Herman Kingma ENT Department Maastricht University Medical Centre The Netherlands how I do
More informationSaccades. Assess volitional horizontal saccades with special attention to. Dysfunction indicative of central involvement (pons or cerebellum)
Saccades Assess volitional horizontal saccades with special attention to Amplitude? Duration? Synchrony? Dysfunction indicative of central involvement (pons or cerebellum) Dynamic Visual Acuity Compare
More informationVestibular System. Dian Yu, class of 2016
Vestibular System Dian Yu, class of 2016 Objectives 1. Describe the functions of the vestibular system: What is it? How do you stimulate it? What are the consequences of stimulation? 2. Describe the vestibular
More informationDraft Guidelines for the Direct Referral of Adults with Hearing Difficulty to Audiology Services (2016)
Draft Guidelines for the Direct Referral of Adults with Hearing Difficulty to Audiology Services (2016) Produced by: Service Quality Committee of the British Academy of Audiology Key Authors: Date of publication:
More informationAUDIOLOGY/ OTOLOGY CLINICAL ASSESSMENT FORM (Includes history, examination, audiological testing and outcome)
(A) DEMOGRAPHICS AUDIOLOGY/ OTOLOGY CLINICAL ASSESSMENT FORM (Includes history, examination, audiological testing and outcome) A1 ID Number A2 Name A3 Date of Birth dd/mm/yy / / A4 Hospital Number A5 Today
More informationControl of eye movement
Control of eye movement Third Nerve Palsy Eye down and out Trochlear Nerve Palsy Note: Right eye Instead of intorsion and depression action of superior oblique See extorsion and elevation Observe how
More informationGuidance for Primary Care: Direct Referral of Adults with Hearing Difficulty to Audiology Services
Guidance for Primary Care: Direct Referral of Adults with Hearing Difficulty to Audiology Services Produced by: Service Quality Committee of the British Academy of Audiology Key Authors: Hanna Jeffery
More informationQuick Guides Vestibular Diagnosis and Treatment:
VNG - Balance Testing Quick Guides Vestibular Diagnosis and Treatment: Utilizing Videonystagmography (VNG) Spontaneous Nystagmus Gaze Test Smooth Pursuit Tracking Saccade Test Optokinetics (OKN) Dix-Hallpike
More informationVestibular System. BAA Conference 2014 Assistant Audiologist Workshop
Vestibular System BAA Conference 2014 Assistant Audiologist Workshop Balance testing - why do we do it? Dizziness / vertigo / unsteadiness / light-headedness Very common Very distressing Nausea / vomiting
More informationHearing Screening, Diagnostics and Intervention
JCIH Newborn Hearing Screening Guidelines 1-3-6 Model By 1 month Screenhearing Hearing Screening, Diagnostics and Intervention By 3 months: Evaluate hearing and complete diagnosticaudiology and otolaryngology
More informationBecause dizziness is an imprecise term, a major role of the clinician is to sort patients out into categories
Dizziness and Imbalance Timothy C. Hain, MD Clinical Professor of Neurology, Otolaryngology, Physical Therapy Chicago Dizziness and Hearing 645 N. Michigan, Suite 410 312-274-0197 Lecture Goals 1. What
More informationAudiology Department Vestibular Assessment and Rehabilitation Procedure
Audiology Department Vestibular Assessment and Classification: Clinical Guideline Lead Author: Neil Summerfield Additional author(s): Maxine Holden Authors Division: Audiology Unique ID: TWCG08(16) Issue
More informationWhat to Do? My Patient Presents with Sudden Hearing Loss: Sam J Daniel, MD
My Patient Presents with Sudden Hearing Loss: What to Do? Sam J Daniel, MD Director Pediatric Otolaryngology Montreal Children s Hospital, McGill University Disclosures There are no conflicts of interest
More informationNo Running Is BPPV Blocking the Path to a Carefree Childhood?
WELCOME BACK to an ongoing series that challenges the audiologist to identify a diagnosis for a case study based on a listing and explanation of the nonaudiology and audiology test battery. It is important
More informationVestibular Function Testing
Vestibular Function Testing Timothy C. Hain, MD Professor Vestibular Tests ENG (electronystagmography) VEMP (Vestibular evoked myogenic responses) Rotatory Chair Posturography Five motion sensors can measure
More informationBenign Paroxysmal Positional Vertigo (BPPV) Structures of importance. The ear is an inertial navigation device. Vestibular Reflexes
Otologic Dizziness (Dizziness from Ear) Structures of importance Timothy C. Hain, MD Northwestern University, Chicago t-hain@northwestern.edu The ear is an inertial navigation device Semicircular Canals
More informationP0 Antigen Detection in Sudden Hearing Loss and Ménière s Disease: A New Diagnostic Marker?
Acta Otolaryngol 2004; 124: 1145/1148 P0 Antigen Detection in Sudden Hearing Loss and Ménière s Disease: A New Diagnostic Marker? DESIDERIO PASSALI 1, VALERIO DAMIANI 1, RENZO MORA 2, FRANCESCO MARIA PASSALI
More informationNormative vestibulo-ocular reflex data in 6-12 year-old children using video head-impulse test
RESEARCH ARTICLE Normative vestibulo-ocular reflex data in 6-12 year-old children using video head-impulse test Siyamak Alizadeh, Nariman Rahbar*, Mohsen Ahadi, Seyyed Jalal Sameni Department of Audiology,
More informationAudiology (Clinical Applications)
(Clinical Applications) Sasan Dabiri, M.D. Assistant Professor Department of Otorhinolaryngology Head & Neck Surgery Amir A lam hospital Tehran University of Medical Sciences Last Updated in February 2015
More informationMEASUREMENTS AND EQUIPMENT FOR AUDIOLOGICAL EVALUATIONS
MEASUREMENTS AND EQUIPMENT FOR AUDIOLOGICAL EVALUATIONS Audiometric results will be analysed according to the following guidelines indicated in literature. 1. Otoscopic Examination The different structures
More informationDelayed Endolymphatic Hydrops: Episodic Vertigo of Delayed Onset after Profound Inner Ear Hearing Loss
Delayed Endolymphatic Hydrops: Episodic Vertigo of Delayed Onset after Profound Inner Ear Hearing Loss Tamio Kamei 1, MD, PhD and Kenji Watanabe 2, MD 1 Professor emeritus at Gunma University, Japan 2
More informationA patient with endolymphatic hydrops may experience any combination of the below described symptoms:
MENIERE S DISEASE Endolymphatic hydrops and Meniere s disease are disorders of the inner ear. Although the cause is unknown, it probably results from an abnormality of the fluids of the inner ear. In most
More informationClassification of magnitude of hearing loss (adapted from Clark, 1981; Anderson & Matkin, 1991)
Diagnostic Classification Terms and Normative Data The following are agreed upon definitions to be used in clinical reports. However, full interpretation of audiological results should be made within the
More informationVertigo. Definition. Causes. (Dizziness) Benign Paroxysmal Positional Vertigo (BPPV) Labyrinthitis. by Karen Schroeder, MS, RD
Vertigo (Dizziness) by Karen Schroeder, MS, RD En Español (Spanish Version) Definition Vertigo is a feeling of spinning or whirling when you are not moving. It can also be an exaggerated feeling of motion
More informationLabyrinthitis and Vestibular Neuritis
Labyrinthitis and Vestibular Neuritis http://www.patient.co.uk/health/labyrinthitis-and-vestibular-neuritis.htm Labyrinthitis and vestibular neuritis are most commonly caused by a viral infection that
More informationVestibular and Balance Disorders in the Pediatric Population
6th Annual Training Course for Health Care Professionals on Vestibular and Balance Disorders in the Pediatric Population Fri. & Sat., October 2-3, 2015 Boston Children s at Waltham 9 Hope Avenue, Waltham,
More informationDiagnostic. Evaluation of Hearing, Tinnitus, and Middle Ear Function
Diagnostic Audiology Pocket Guide Evaluation of Hearing, Tinnitus, and Middle Ear Function Editor-in-Chief for Audiology Brad A. Stach, PhD Diagnostic Audiology Pocket Guide Evaluation of Hearing, Tinnitus,
More informationOtoscopy and Tympanometry Revisited Skill Refresher for SLPs
Otoscopy and Tympanometry Revisited Skill Refresher for SLPs Susan Lopez, MA, CCC-A Melanie Randle, MS, CCC-A University of Mississippi Learning Objectives You will learn the diagnostic goals of tympanometry
More informationCoding Fact Sheet for Primary Care Pediatricians
1/1/2016 Hearing Testing Coding Fact Sheet Coding Fact Sheet for Primary Care Pediatricians While coding for hearing screening is relatively straightforward, ensuring that appropriate payment is received
More informationPreparing for Vestibular Testing
Patient Name: Appointment Date: Appointment Time: am / pm Vestibular Evoked Myogenic Potential (VEMP) Vestibular Evoked Myogenic Potential (VEMP) is a neurophysiological assessment technique used to determine
More informationTemporal bone imaging in osteogenesis imperfecta patients with hearing loss
Temporal bone imaging in osteogenesis imperfecta patients with hearing loss F. Swinnen 1, J. Casselman 2, P. Coucke 3, C. Cremers 4, E. De Leenheer 1, I. Dhooge 1 (1) Departement of Otorhinolaryngology,
More informationSmooth Pursuit Neck Torsion Test A Specific Test for Whiplash Associated Disorders?
Smooth Pursuit Neck Torsion Test A Specific Test for Whiplash Associated Disorders? 1 Journal of Whiplash & Related Disorders, Vol. 1, Issue 2, 2002, pgs. 9-24 Carsten Tjell, Artur Tenenbaum, Sören Sandström
More informationOtologic (Ear) Dizziness Fistula SCD Bilateral. Other. Neuritis BPPV. Menieres
Otologic Dizziness (Dizziness from Ear) Ear Structures of importance Timothy C. Hain, MD Northwestern University, Chicago t-hain@northwestern.edu The ear is an inertial navigation device Semicircular Canals
More informationCorrespondence should be addressed to L. E. Walther;
Case Reports in Otolaryngology Volume 2013, Article ID 168391, 5 pages http://dx.doi.org/10.1155/2013/168391 Case Report Dynamic Change of VOR and Otolith Function in Intratympanic Gentamicin Treatment
More informationAcquired Deafness Loss of hearing that occurs or develops sometime in the course of a lifetime, but is not present at birth.
Page 1 of 5 URMC» Audiology Glossary of Terms A Acoustic Neuroma A tumor, usually benign, which develops on the hearing and balance nerves and can cause gradual hearing loss, tinnitus, and dizziness. Acquired
More informationSTICKLER SYNDROME: AN UNDERDIAGNOSED DISEASE. REPORT OF A FAMILY. DE KEYZER THW*, DE VEUSTER I*, SMETS R-M E*
STICKLER SYNDROME: AN UNDERDIAGNOSED DISEASE. REPORT OF A FAMILY. DE KEYZER THW*, DE VEUSTER I*, SMETS R-M E* ABSTRACT Purpose: To report a family diagnosed with Stickler syndrome. To emphasize that early
More informationDIAGNOSIS Causes/Etiology of Hearing Loss
DIAGNOSIS Causes/Etiology of Hearing Loss DIAGNOSIS Causes/Etiology of Hearing Loss VI. How Do We Hear? Sound waves enter our ears and are amplified by the ear drum and middle ear bones (ossicles), allowing
More informationManchester Adult Cochlear Implant Programme
Manchester Royal Infirmary Manchester Adult Cochlear Implant Programme Information for Patients and Professionals Contents Introduction 3 The normal ear 4 The cochlear implant 5 The assessment procedure
More informationThe balance organs and dizziness
The balance organs and dizziness 1 of 12 Contents 3 What is inside your ear? 4 What keeps you balanced? 4 How do the balance organs work? 5 How do the balance organs control your eye movements? 7 Why do
More informationHandheld OAE-Tympanometry Combination System
Handheld OAE-Tympanometry Combination System The ONLY handheld OAE-TYMP combination testing device in the world! www.maico-diagnostics.com Visual Evaluation Ear Canal Middle Ear Evaluation Eardrum Cochlea
More informationDizziness: Natural Treatment for Vertigo and BPPV
Wellness and WBV Studio Home» Bodywork» Massage» CranioSacral Therapy» Dizziness: Natural Treatment for Vertigo and BPPV CRANIOSACRAL THERAPY HOLISTIC HEALING Dizziness: Natural Treatment for Vertigo and
More informationHearing 101. Presented by: Hearing Neuro Health, Bridgett Wallace, PT, DPT. Brad Melancon, MS, FAAA
Hearing 101 Brought to you by 360 Balance & Hearing Presented by: Bridgett Wallace, PT, DPT Physical Therapist and Educator Owner of 360 Balance & Hearing 20+ years specializing in dizziness & balance
More informationG. Doobe, 1 A. Ernst, 1 R. Ramalingam, 2 P. Mittmann, 1 and I. Todt Introduction. 2. Materials and Methods
BioMed Research International Volume 2015, Article ID 457318, 4 pages http://dx.doi.org/10.1155/2015/457318 Research Article Simultaneous Labyrinthectomy and Cochlear Implantation for Patients with Single-Sided
More informationAdvanced Diagnostic Audiometric Testing to Aid In Differential Diagnosis, Measure Patient Outcomes, and Interesting Case Studies
Advanced Diagnostic Audiometric Testing to Aid In Differential Diagnosis, Measure Patient Outcomes, and Interesting Case Studies Abstract: This presentation will focus on advanced audiometric techniques
More informationCase Report Intra-Attack Vestibuloocular Reflex Changes in Ménière s Disease
Case Reports in Otolaryngology Volume 216, Article ID 2427983, 4 pages http://dx.doi.org/1.1155/216/2427983 Case Report Intra-Attack Vestibuloocular Reflex Changes in Ménière s Disease Dario A. Yacovino
More informationAssessing the Deaf & the Dizzy. Phil Bird Senior Lecturer University of Otago, Christchurch Consultant Otolaryngologist CPH & Private
Assessing the Deaf & the Dizzy Phil Bird Senior Lecturer University of Otago, Christchurch Consultant Otolaryngologist CPH & Private Overview Severe & profoundly deaf children & adults Neonatal screening
More informationAudiometric Techniques Program in Audiology and Communication Sciences Pediatric Audiology Specialization
Audiometric Techniques Program in Audiology and Communication Sciences Pediatric Audiology Specialization The contents of this presentation were developed under a grant from the US Department of Education,
More informationOcular Motor Function in Patients with Bilateral Vestibular Weakness
Original Article Iranian Journal of Otorhinolaryngology, Vol.28(3), Serial No.86, May 2016 Ocular Motor Function in Patients with Bilateral Vestibular Weakness Seyyed Amir Hossein Ghazizadeh Hashemi 1,
More informationEvaluation & Management of Vestibular Disorders
Evaluation & Management of Vestibular Disorders Richard A. Roberts, Ph.D., FAAA Alabama Hearing & Balance Associates, Inc. Disclosure and Copyright Statements Richard Roberts has no financial or nonfinancial
More informationDOWNLOAD OR READ : VESTIBULAR EVOKED MYOGENIC POTENTIAL ITS BASICS AND CLINICAL APPLICATIONS PDF EBOOK EPUB MOBI
DOWNLOAD OR READ : VESTIBULAR EVOKED MYOGENIC POTENTIAL ITS BASICS AND CLINICAL APPLICATIONS PDF EBOOK EPUB MOBI Page 1 Page 2 vestibular evoked myogenic potential its basics and clinical applications
More informationSupplementary appendix
Supplementary appendix This appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors. Supplement to: Patel M, Agarwal K, Arshad Q, et al. Intratympanic
More informationSchedule of Accreditation issued by United Kingdom Accreditation Service 2 Pine Trees, Chertsey Lane, Staines-upon-Thames, TW18 3HR, UK
2 Pine Trees, Chertsey Lane, Staines-upon-Thames, TW18 3HR, UK Westmorland General Hospital Burton Road Kendal LA9 7RG United Kingdom Contact: Samantha Riding Tel: +44 (0) 7775777976 Fax: +44 (0) 1524583712
More informationCold Thermal Irrigation Decreases the Ipsilateral Gain of the Vestibulo-Ocular Reflex
Cold Thermal Irrigation Decreases the Ipsilateral Gain of the Vestibulo-Ocular Reflex Laszlo T. Tamás, 1 Konrad P. Weber, 2,3 Christopher J. Bockisch, 2,3,4 Dominik Straumann, 2 David M. Lasker, 5 Béla
More informationUPDATE ON ELECTROPHYSIOLOGIC MEASURES OF HEARING SENSITIVITY IN INFANTS
UPDATE ON ELECTROPHYSIOLOGIC MEASURES OF HEARING SENSITIVITY IN INFANTS Why do we need frequency-specific stimuli? Percent of Audiograms 50 Pittman & Stelmachowicz (2002) 40 30 20 10 Adults Children 0
More informationClinical application of tympanometry in the topic diagnosis of hearing loss A study from Bulgaria
ISSN: 2347-3215 Volume 3 Number 5 (May-2015) pp. 66-73 www.ijcrar.com Clinical application of tympanometry in the topic diagnosis of hearing loss A study from Bulgaria Sonya Varbanova, D. Konov*, Spiridon
More informationTaste buds Gustatory cells extend taste hairs through a narrow taste pore
The Special Senses Objectives Describe the sensory organs of smell, and olfaction. Identify the accessory and internal structures of the eye, and explain their function. Explain how light stimulates the
More informationPediatric Hearing Screening Training for the PCA. Gouverneur Healthcare Services 227 Madison Street New York, NY 10002
Pediatric Hearing Screening Training for the PCA Gouverneur Healthcare Services 227 Madison Street New York, NY 10002 Preface The purpose of any hearing screening program is to ensure early identification
More informationApplication of the Video Head Impulse Test to Detect Vertical Semicircular Canal Dysfunction
Otology & Neurotology 34:974Y979 Ó 2013, Otology & Neurotology, Inc. Commentary Application of the Video Head Impulse Test to Detect Vertical Semicircular Canal Dysfunction *Hamish G. MacDougall, Leigh
More informationAudiology. Anita Gáborján MD, PhD.
Audiology Anita Gáborján MD, PhD. Scope of audiology Is there a hearing loss? (Tinnitus? Vertigo? Neurological symptom? Speech development? ) How severe is the hearing loss? What is the reason of the hearing
More informationVestibular Symptoms in Concussion: Medical/Surgical Perspective. Jacob R. Brodsky, MD Boston Children s Hospital
Vestibular Symptoms in Concussion: Medical/Surgical Perspective Jacob R. Brodsky, MD Boston Children s Hospital jacob.brodsky@childrens.harvard.edu On Field Symptoms Headache Dizziness Confusion Fatigue
More informationA NORMATIVE STUDY ON AIR AND BONE CONDUCTION OCULAR VESTIBULAR EVOKED MYOGENIC POTENTIALS. Ho Sen Kee
A NORMATIVE STUDY ON AIR AND BONE CONDUCTION OCULAR VESTIBULAR EVOKED MYOGENIC POTENTIALS Ho Sen Kee INTRODUCTION Dizziness and imbalance are two of the most frequent complains amongst the elderly population.
More informationA GUIDE TO REFERRAL OF COMMON ENT CONDITIONS Vince Cumberworth ENT Consultant North West London Hospitals EAR
A GUIDE TO REFERRAL OF COMMON ENT CONDITIONS Vince Cumberworth ENT Consultant North West London Hospitals 25.1.2012 EAR TINNITUS Tinnitus is the sensation of sound which does not come from an external
More informationSchedule of Accreditation issued by United Kingdom Accreditation Service 2 Pine Trees, Chertsey Lane, Staines-upon-Thames, TW18 3HR, UK
2 Pine Trees, Chertsey Lane, Staines-upon-Thames, TW18 3HR, UK Ropewalk House 113 Ropewalk Nottingham NG1 5DU Contact: Claire Benton Tel: +44 (0) 115 948 5550 Fax: +44 (0) 115 948 5515 Adults +44 (0)155
More information