Hearing and Balance Center

For those of you who have been scheduled for balance testing, the following is an overview of the tests and possible restrictions.  Please contact our office if you have any questions or concerns 412-321-2480.

ARRIVAL:

Please always arrive 30 minutes prior to your scheduled testing time.

RESTRICTIONS:

***Not all tests require restrictions.  Please see your specific test for this information.

1.  No alcoholic beverages for two days (48 hours) prior to your testing.

2.  No food or drink (clear tea and/or black coffee is allowed) 4 hours prior to your testing.  If you are diabetic, or feel that you cannot wait for several hours to eat, please bring a snack to eat after the testing.  If your testing is scheduled in the afternoon, you may eat a light breakfast early in the morning.

3.  No eye or facial make-up (including mascara/eyeliner), cold creams, or lotions on the day of testing.

4.  The following medications, taken within 48 hours prior to testing may affect the test results, or prevent completion of the testing.  Please avoid unless absolutely necessary the following medications:

  • Sleeping Medications
  • Tranquilizers
  • Pain Medications (you may take Tylenol)
  • Anti-dizzy Medications (Antivert/Meclizine)
  • Anti-nausea Medications (Compazine, Phenergan)
  • Dilantin or other anti-seizure medications (You may take the day prior to testing.  DO NOT take the day of testing.  Bring medication with you to your appointment.
  • Anti-depressants
  • Narcotics/Barbiturates
  • Cold Medications
  • Antihistamines

CHECK WITH YOUR PHYSICIAN IF YOU ARE UNSURE IF ONE OF THE ABOVE MEDICATIONS YOU ARE TAKING IS ABSOLUTELY NECESSARY OR CALL US AT 412-321-2480 IF YOU HAVE QUESTIONS.

5.  You may continue to take life sustaining medications such as blood pressure, cardiac, diabetes and thyroid medications with a sip of water on the day of testing.

6.  Please wear comfortable clothing (i.e.- pants instead of a skirt or dress) on the day of testing.

7.  If you wear hard contacts of gas permeable lenses please wear eye glasses.

TEST DESCRIPTIONS:

Electro/Videonystagmography (ENG/VNG):  

Evaluates the brain and inner ear balance systems; to determine which side may be causing the problem.  Small monitor are placed around the eye OR goggles are placed over the eyes.  Throughout the test, the patient’s eye movements are monitored while the patient looks in specific directions and moves his/her head in various ways.  Cool and warm temperature changes are introduced to the ear to evaluate the systems’s responses.  This is a painless test that takes approximately 1 hour.  The patient may experience very short durations (less than 2-4 minutes) of dizziness periodically throughout the test.  Patients should follow restrictions listed above.

Rotary Chair Test:

Evaluates the brain and inner ear balance systems to measure compensation following an inner ear problem.  Goggles are worn around the eyes to record eye movements in response to various visual and rotary stimuli during testing.  The patient’s head is placed in a head band to keep the head still during testing.  The patient sits in the dark in a small room and follows a laser light on the wall with his/her eyes.  The chair rotates slowly left and right while the patient is asked simple questions to assure that he/she is alert.  This is a painless test that takes approximately 15-20 minutest to complete.  We allow for 45 minutes of testing time to ensure there is enough time for test completion and analysis.  Most patient’s complete this test with very little to no dizziness. Patients should follow restrictions listed above.

Infrared Video Goggle Positional Test (IRV):

Observes and records any abnormal eye movements which may be consistent with positional vertigo.  The patient wears face goggles which are equipped with an infrared video camera and a microphone.  The patient is in darkness throughout the testing and is placed on an examination table in various head and body positions.  This is a painless test that takes approximately 10-20 minutes to complete.  Patients may experience dizziness in certain positions; however, the dizziness usually subsides quickly.  Patients should follow restrictions listed above.

Vestibular Autorotation Test (VAT):

Evaluates the inner ear balance system with faster head movements.  Goggles are worn around the eyes to monitor eye movements during testing.  While keeping his/her eyes on a target the patient shakes his/her head in time to a computer generated tone.  This is a painless test that takes approximately 20-30 minutes to complete.  Generally patients do not get dizzy during this test.  Patients should follow restrictions listed above.

Auditory Brainstem Response Audiometry (ABR, AEP, BSER, and BAER):

Used to identify the cause of specific medical conditions and/or to determine hearing loss in certain populations.  Small monitors are placed on both earlobes and on the forehead.  The patient will listen to sounds presented through insert earphones while resting comfortably.  No response from the patient is necessary; the patient rests quietly and can even fall asleep.  This is a painless test that takes approximately 1 hour to complete.  Patient’s do not have restrictions for this test, however we ask that you do not wear make-up/creams/lotions on the face the day of testing, to ensure that the monitors adhere properly.

Posturography:

Evaluates a patient’s ability to maintain balance under various conditions and to identify which system is causing the balance problems.  The patient stands in a semi-enclosed space while the floor and visual surrounds are gradually moved.  The patient is advised of each upcoming movement so as not to be startled.  The patient will wear a harness and will be securely clipped in to ensure that they do not fall.  Small sensors under the floor board assist in evaluating how the body responds to various environmental changes.  The patient must be able to stand unsupported for a short period of time.  This is a painless test that takes approximately 45 minutes to complete.  There are no restrictions for patients to follow.

Electrocochleography (EcoG):

Evaluates the cochlea’s response to sound.  EcoG is most often used to confirm the presence of Meniere’s disease.  A small monitor is placed in the ear canal via an insert earphone.  Sticker monitors are also placed on the earlobes and on the forehead.  Sound is delivered to the ear while the monitor measures the response of the cochlea and auditory nerve.  Throughout the procedure the patient rests comfortably and can even fall asleep.  This is a painless test that takes approximately 45-60 minutes to complete and requires no response from the patient.  Patient’s do not have restrictions for this test, however we ask that you do not wear make-up/creams/lotions on the face the day of testing, to ensure that the monitors adhere properly.

Electroneuronography (EnoG):

Evaluates the integrity of the facial nerve.  Small monitors are placed on the side of the nose and forehead.  the patient sits quietly while a stimulator sends electrical pulses to the facial nerve.  The response is recorded on a computer and a comparison is made between the right and left side of the face.  EnoG is a very short test; actual test time is less than 5 minutes, however we will schedule 30 minutes to allow for set up and analysis of the results.  Patient’s do not have restrictions for this test, however we ask that you do not wear make-up/creams/lotions on the face the day of testing, to ensure that the monitors adhere properly.

Vestibular Evoked Myogentic Potential (VEMP):

Performed on patients who experience noise induced dizziness or dizziness that is provoked by lifting heavy objects or bearing down.  Monitors are placed on the neck and forehead.  Soft insert earphones are placed into the ear canals.  The patient will be required to lift his/her head off of the exam table while in a supine position.  They will then be asked to turn their head 45-90 degrees to either the left or right and hold that position for approximately 20-30 seconds.  This is repeated several times with resting in-between each trial.  Sounds of varying but moderate intensities are played in the ears during each trial.  This is a painless test that lasts approximately 30 minutes.  Some patients do experience fatigue of the neck and abdomen muscles during the test.  Patient’s do not have restrictions for this test, however we ask that you do not wear make-up/creams/lotions on the face or neck the day of testing, to ensure that the monitors adhere properly.