Vestibular Assessment at The Art of Hearing

Audio-vestibular assessment

Involves a comprehensive evaluation of both hearing and balance. This includes detailed and personalised medical and psychosocial history, hearing tests such as pure-tone audiometry, bedside audio-vestibular examinations, clinical observation of balance and movement, and specialised vestibular testing using advanced diagnostic equipment.

Vestibular tests that may be performed

The Audiologist may modify the assessment depending on your symptoms, comfort or the findings obtained during testing. Your assessment may include all or some of the following:

Semicircular canal positioning tests

Why: To determine whether displaced calcium crystals within the inner ear are causing your dizziness or vertigo, during changes in head position.

What to expect: You will be guided through a series of gentle head and body movements while your eye movements are recorded using video goggles. The test may briefly reproduce your symptoms.

Canal repositioning manoeuvres

Following the canal positioning tests, a repositioning manoeuvre can often be performed immediately to relieve your symptoms. The choice of manoeuvre depends on the type and location of BPPV and is tailored to the individual.

Video Head Impulse Test (vHIT)

Why: Measures how each semicircular canal functions during quick head movements.
What to expect: You wear lightweight goggles and while focusing on a target, the Audiologist quickly moves your head to each side.

Video Nystagmography (VNG)

Why: Measures how your eyes move while following targets. Helps determine whether symptoms originate from the inner ear, brain, cerebellum or nerves of the eye (central cause).
What to expect: You wear infrared goggles and complete simple visual tasks.

Caloric Testing

Why: Assesses each inner ear’s function separately (specifically the horizontal canal) using warm and cool air. This test helps determine whether one ear is responding less than the other, indicating if one or both sides have reduced or absent signals to the brain.

What to expect: You may briefly feel dizzy or nauseous; this settles quickly.

Cervical Vestibular Evoked Myogenic Potential (cVEMP)

Why: Assesses saccule and inferior vestibular nerve function.
What to expect: Electrodes are placed on your neck while sound or vibration is presented. The sounds used during VEMP testing are brief but may be loud.

Ocular Vestibular Evoked Myogenic Potential (oVEMP)

Why: Assesses utricle and superior vestibular nerve function.
What to expect: Electrodes are placed below your eyes while you look upwards. The sounds used during VEMP testing are brief but may be loud.

Vibration-Induced Nystagmus (VIN) Test

Why: A vibrating stimulus is applied over the mastoid bones to determine whether vibration provokes involuntary eye movements (nystagmus). This can help identify an imbalance between the two vestibular systems and is useful in unilateral vestibular disorders.
What to expect: A small handheld vibrator is placed behind each ear for a few seconds while your eye movements are recorded.