Balance disorders or dizziness is one of the most difficult complaints to assess because it is a subjective sensation that cannot be directly and objectively measured.  It frequently represents many separate overlapping sensations that can be caused by a multitude of different pathophysiologic processes.  Evaluation and treatment of people who are suffering from problems with balance differs greatly, depending on the types of problems they are having.  Adirondack Audiology Associates incorporates the latest diagnostic technologies to ensure our patients receive a thorough and complete analysis in finding a solution to their problem.

Audiologic Testing
Audiology tests can provide information about hearing, middle ear function, cochlear hair cell function and several neural aspects of the hearing-balance system. Although there are many ear related conditions, which cause hearing loss along with vertigo, there are many that do not. So, the presence of an accompanying hearing loss with the vertigo symptoms may help differentiate certain ear disease-disorders from one another. For example, Meniere’s disease and labyrinthitis typically has both hearing loss and vertigo, whereas vestibular neuronitis and BPPV only have the symptom of vertigo.

Gans Sensory Organization Performance
A combination of the Romberg, clinical test of sensory integration of balance (CTSIB) and Fukuda Stepping Tests provide qualitative information on whether an equilibrium dysfunction exists, whether it is CNS or peripheral and also serves as an indicator of impact on balance function. Whether the is patient surface or visually dependent gives insight into the status of the vestibular system. Recovery of function post treatment may also be documented..

Computerized Dynamic Visual Acuity
This tests for a change in vision with controlled head movement. Oscillopsia is a breakdown in gaze stabilization during active head movement caused by peripheral or central vestibular disorders. The abnormal vestibulo-ocular reflex (VOR) function of as little as 3 degrees can change vision from 20/20 to 20/200 simple head movements. The vision test is conducted while the patient produces horizontal and then vertical head movement of 2.5 cycles per second. This is in the low-mid range of normal active head movement. The test indicates the function problem caused by the vestibular dysfunction and can be used as a baseline to latter compare improvement post Vestibular Rehabilitation Therapy (VRT) to document the treatment efficacy.

Vestibular Autorotation Testing
VOR function gain and phase is quantitatively analyzed using this active rotation test for both horizontal and vertical head movements over a frequency range of approximately 2-8 cycles per second. This indicates the direction of head movement, which is most dysfunctional as well as the frequency (speed) of head movement. The patient is required only to look straight ahead while moving their head to an auditory cueing signal. This test as those mentioned above provides diagnostic as well as outcome measurements. This test can be obtained through passive tests like the Rotary Chair, in which the patient simply sits while being harmonically accelerated or active tests, in which the person volitionally moves their head to an auditory cue.