The dizziness and balance disorders program at The Ohio State University Wexner Medical Center offers state-of-the-art testing and treatment for patients with vestibular dysfunction, also known as ear-related dizziness. Testing for this type of dizziness may include a videonystagmography (VNG), video head impulse test (vHIT), cervical and ocular vestibular myogenic evoked potentials (cVEMPs/oVEMPs), and diagnostic audiometric evaluations.The mission of our team is to promote improved diagnosis, treatment and understanding of dizziness, imbalance and related conditions through an integrated partnership between clinicians and researchers. Many of the conditions causing ear-related dizziness are monitored by a neurotologist and treated by an advanced practice provider.
Dizziness and balance conditions
Labyrinthitis/Inner ear infection
Superior semicircular canal dehiscence syndrome (SSCD)
How do you test for dizziness and balance disorders?
Vestibular testing involves several diagnostic procedures used to determine the causes of dizziness and imbalance, with particular focus on conditions affecting the portions of the inner ear and central nervous system involved in balance and visual stability. Determining the causes allows for selection of appropriate treatment. Common testing methods include:
- The VNG test battery uses recording and analysis of eye movements in response to a variety of stimuli to determine the cause of a patient’s dizziness and imbalance. Through analysis of eye movements related to gaze stabilization and target following, the recordings provide useful information on the function of parts of the balance system, including the balance organs and nerves within in the ears, the portions of the balance system within the central nervous system (CNS) and the parts of the CNS responsible for generation and control of eye movements.
- At Ohio State Wexner Medical Center, we perform a VNG test with the patient in an exam chair in a darkened room, usually wearing goggles equipped with infrared cameras. Under certain circumstances, we use electrodes placed around the eyes (electronystagmography (ENG)). The test system records eye movements while the patient watches visual stimuli, moves in different positions, and undergoes irrigations with warm and cool fluids in each ear.
- The test findings provide information on whether symptoms result from dysfunction within the ear, the CNS or both, helping determine the cause of symptoms. The test usually takes 60 to 75 minutes.
Vestibular-Evoked Myogenic Potentials (VEMPs)
- VEMPs are myogenic (muscle) responses believed to be triggered by stimulation of the otolith organs. These organs are part of the inner ear balance system responsible for detecting both linear movements (forward/backward, side-to-side, up/down) and head orientation with respect to gravity.
- We use VEMPs testing to determine whether an abnormal opening (dehiscence) or thinning of the bone that surrounds the inner ear contributes to a patient’s symptoms. We also use it to investigate for dysfunction in the balance portions of the inner ear, including otolith organs and their related pathways through the vestibular nerve and the central nervous system.
- We measure cervical VEMPs responses through electrodes placed on the neck while the patient lifts and turns the head and listens to a repeated loud popping stimulus that provokes the response. We measure ocular VEMPs through electrodes placed under the eyes while the patient gazes upward and listens to the same stimulus. The test usually takes 45 to 60 minutes.
Video Head Impulse Test (vHIT)
- vHIT uses high speed video recording through infra-red goggles of eye movements that occur during small, rapid head movements to test for the presence of dysfunction within the balance organs and their neural pathways.
- During the test, the patient stares at a target while the examiner moves the patient’s head quickly in the three planes of the balance organs (semicircular canals) responsible for detection of head turns and gaze stabilization during them. Defective eye movement patterns which result suggest very specific areas of dysfunction within the inner ear balance organs and nerves. The test takes approximately 15 minutes.
Dizziness and balance disorder treatment
Intra-tympanic steriod injections
Our Vestibular Audiology Team
Julie Colaianni, AuD
Saul Strieb, AuD
Audiologist & Vestibular Laboratory Coordinator
Saul Strieb, AuD, obtained his bachelor’s degree from the University of Chicago and his master’s degree in Audiology from the University of Maryland. He received his doctoral degree in Audiology from the University of Florida in 2009. He served as an audiologist at the Washington Hospital Center from 2001 through 2011, before joining the staff of the Ohio State Department of Otolaryngology–Head and Neck Surgery in 2011. His clinical interests include hearing aids, BAHA, vestibular assessment and treatment of benign paroxysmal positional vertigo.