Search Our Scientific Publications & Authors

J Vestib Res 2022 ;32(3):245-260

Boys Town National Research Hospital, Center for Childhood Deafness, Language and Learning, Omaha, NE, USA.

Background: In adults, vestibular loss is associated with cognitive deficits; however, similar relationships have not been studied in children.

Objective: Evaluate the effect of vestibular loss on working memory and executive function in children with a cochlear implant (CCI) compared to children with normal hearing (CNH).

Methods: Vestibular evoked myogenic potential, video head impulse, rotary chair, and balance testing; and the following clinical measures: vision, hearing, speech perception, language, executive function, and working memory. Read More

Cureus 2022 Jan 20;14(1):e21460. Epub 2022 Jan 20.

Otolaryngology - Head and Neck Surgery, University of California San Francisco, San Francisco, USA.

Introduction While the mechanism of posterior canal benign paroxysmal positional vertigo (BPPV) is widely accepted as canalolithiasis, the pathophysiology of horizontal canal BPPV remains controversial. We seek to analyze vestibular test results of patients with horizontal canal BPPV with ageotropic nystagmus (AHC) and geotropic nystagmus (GHC) in comparison to patients with posterior canal BPPV (PC) to better understand its pathophysiology. Methods In a retrospective chart review of adults with BPPV at a tertiary referral balance center, we reviewed the clinical characteristics and compared videonystagmography, caloric, rotary chair, subjective visual vertical (SVV)/ subjective visual horizontal (SVH), and vestibular evoked myogenic potential (VEMP) results between groups. Read More

Ear Hear 2022 May/Jun;43(3):1003-1012

Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA.

Objectives: Although emerging evidence suggests that hearing loss (HL) is an independent risk factor for falls, it is unclear how HL may impact falls risk in adults with vestibular dysfunction and nonvestibular dizziness. The purpose of this study was to characterize the impact of HL on falls in patients with vestibular dysfunction and nonvestibular dizziness relative to a group of patients without dizziness. In addition, this study aimed to evaluate whether there was an interactive effect between HL and vestibular dysfunction or nonvestibular dizziness on the odds of falling. Read More

Front Neurol 2021 21;12:714543. Epub 2021 Oct 21.

Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, United States.

Hearing loss (HL) is the most common sensory deficit in humans and is frequently accompanied by peripheral vestibular loss (PVL). While often overlooked, PVL is an important sensory dysfunction that may impair development of motor milestones in children and can have a significant negative impact on quality of life. In addition, many animal and models of deafness use vestibular hair cells as a proxy to study cochlear hair cells. Read More

Brain Inj 2021 11 8;35(12-13):1496-1509. Epub 2021 Sep 8.

School of Physical and Occupational Therapy, McGill University, Montreal, Canada.

To identify the tests and tools used to evaluate vestibulo-ocular reflex (VOR) function after traumatic brain injury (TBI) in all age groups and across TBI severity. An electronic search was conducted to include relevant peer-reviewed literature published up to November 2019. Studies included those done with humans, of all ages, and had assessments of oculomotor and/or vestibulo-ocular function in TBI. Read More

Am J Audiol 2021 Sep 20;30(3):755-760. Epub 2021 Aug 20.

Ear, Nose, Throat, and Audiology, CHI Health, Omaha, NE.

Purpose The purpose of this study was to investigate the effectiveness of different types of tasking on the measurement of peak slow phase velocity (SPV) for caloric testing and rotary chair testing. Method This study evaluated the peak SPV response for caloric testing and rotary chair across five conditions. Three verbal, one tactile, and one condition without tasking were used for both caloric testing and rotary chair. Read More

Otolaryngol Clin North Am 2021 Oct 20;54(5):875-891. Epub 2021 Jul 20.

Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, 420 Delaware Street, MMC 396, Minneapolis, MN 55455, USA.

While the majority of vestibular disorders may be diagnosed solely on clinical grounds, a variety of clinical scenarios exist in which objective functional assessment of the vestibular system provides data that facilitate diagnosis and treatment decisions. There exists a veritable armamentarium of sophisticated vestibular test modalities, including videonystagmography, rotary chair testing, video head impulse testing, and vestibular-evoked myogenic potentials. This article aims to help clinicians apply an accessible decision-making rubric to identify the clinical scenarios that may and may not benefit from data derived from specific vestibular function tests. Read More

Pediatrics 2021 02 8;147(2). Epub 2021 Jan 8.

Departments of Pediatrics.

Background And Objectives: Congenital cytomegalovirus (cCMV) is the leading nongenetic cause of sensorineural hearing loss and developmental disabilities. Because there are limited data from studies of vestibular involvement in select groups of children with cCMV, the true frequency of vestibular disorders in cCMV is likely underestimated. Our objective for this study is to determine the prevalence of vestibular, gaze, and balance disorders in a cohort of children with asymptomatic cCMV. Read More

Am J Audiol 2020 Dec 17;29(4):898-906. Epub 2020 Nov 17.

Department of Audiology, Boys Town National Research Hospital, Omaha, NE.

Purpose Conflicts among video head impulse testing (vHIT) and rotary chair have occurred; therefore, the purpose of this study was to determine the relationship between rotary chair and vHIT outcome parameters to understand when these two tests disagree and determine if one or both test outcomes are needed in children. Method Data from 141 child and young adult subjects (73 males, 68 females, = 15 years, range: 6-35) were retrospectively reviewed. Of those, 56 had a cochlear implant and 85 were normal controls. Read More

Laryngoscope Investig Otolaryngol 2020 Jun 4;5(3):560-571. Epub 2020 Jun 4.

Department of Head and Neck Surgery and Communication Sciences Duke University School of Medicine Durham North Carolina USA.

Objectives: The purpose of this study was to assess the effects of cochlear implantation on the functional integrity of the horizontal semicircular canal using multiple methodologies, and to discuss and highlight the limitations of using isolated vestibular tests to assess vestibular function in surgical ears.

Methods: Ten cochlear implant patients were consented to undergo a preoperative and 3-month postoperative vestibular assessment. The horizontal semicircular canal (SCC) was assessed using three different vestibular test measures that assess function using different stimuli and at different frequencies ranges: caloric testing, sinusoidal harmonic acceleration testing in the rotary chair, and video head impulse testing in the plane of the horizontal SCC. Read More

Scand J Immunol 2020 Nov 3;92(5):e12923. Epub 2020 Aug 3.

Department of Transplant Immunology and Immunogenetics, All India Institute of Medical Sciences, New Delhi, India.

Antibody-mediated rejections (AMR) in the absence of circulating anti-HLA-DSA have highlighted the role of non-HLA antibodies, particularly those directed against endothelial cells. Of these, MICA (major histocompatibility complex class I chain-related molecule A) antibodies are the most notable and important because of their potential in promoting graft rejections. Limited studies have focused on the impact of MICA donor-specific antibodies (DSA) on graft outcome as compared to those that are not donor-specific (NDSA). Read More

Int J Audiol 2020 05 26;59(5):360-366. Epub 2019 Dec 26.

Department of Audiology and Speech Pathology, University of Tennessee Health Science Center, Knoxville, TN, USA.

To investigate whether the use of mental tasking, when compared to no mental task, affects measurement of nystagmus response with regard to gain, phase & symmetry, and artefact when utilising video-oculography (VOG) as the measurement technique in rotary chair testing (RCT). A within-subject repeated-measures design was utilised. Seventeen (17) healthy adults were evaluated (age 22-25 years). Read More

JAMA Otolaryngol Head Neck Surg 2020 02;146(2):143-149

Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis.

Importance: Variations in diagnostic test use may indicate that there are opportunities for quality improvement in vestibular health care. To date, the extent to which clinician acquisition of tests varies nationwide by region and specialty of the clinician is unknown.

Objective: To quantify variation in clinician use and payments for audiograms and vestibular tests across all geographic regions of the United States and by specialty of practice. Read More

J Chiropr Med 2019 Jun 1;18(2):144-154. Epub 2019 Jul 1.

Dr. Sid E. Williams Center for Chiropractic Research, Life University, Marietta, Georgia.

Objective: The purpose of this report is to describe care of a patient with chronic progressive external ophthalmoplegia and bilateral vestibular hypofunction.

Clinical Features: A 66-year-old patient presented with limited eye movement and mild ptosis, which led to a diagnosis of chronic progressive external ophthalmoplegia. Rotary chair testing suggested vestibular involvement. Read More

J Vestib Res 2019;29(4):161-170

Department of Neurology and German Center for Vertigo, Ludwig Maximilians University, Munich, Germany.

This paper describes the diagnostic criteria for presbyvestibulopathy (PVP) by the Classification Committee of the Bárány Society. PVP is defined as a chronic vestibular syndrome characterized by unsteadiness, gait disturbance, and/or recurrent falls in the presence of mild bilateral vestibular deficits, with findings on laboratory tests that are between normal values and thresholds established for bilateral vestibulopathy.The diagnosis of PVP is based on the patient history, bedside examination and laboratory evaluation. Read More

J Neurol Phys Ther 2019 07;43(3):153-159

Department of Physical Therapy (J.B.C., G.D.C., A.A.), Department of Optometry and Vision Science (C.B., M.W.S., K.K.W.), and Vision Science Research Center (C.B.), University of Alabama at Birmingham.

Background And Purpose: According to the most recent consensus statement on management of sport-related concussion (SRC), athletes with suspected SRC should receive a comprehensive neurological examination. However, which measures to include in such an examination are not defined. Our objectives were to (1) evaluate test-retest reliability and normative data on vestibular and balance tests in athletes without SRC; (2) compare athletes with and without SRC on the subtests; and (3) identify subtests for concussion testing protocols. Read More

Ear Hear 2020 Jan/Feb;41(1):125-135

Walter Reed National Military Medical Center (WRNMMC, National Military Audiology and Speech Pathology Center), Bethesda, Maryland, USA.

Objectives: The Subjective Visual Vertical (SVV) test and the closely related Rod and Disk Test (RDT) are measures of perceived verticality measured in static and dynamic visual backgrounds. However, the equipment used for these tests is variable across clinics and is often too expensive or too primitive to be appropriate for widespread use. Commercial virtual reality technology, which is now widely available, may provide a more suitable alternative for collecting these measures in clinical populations. Read More

Adv Otorhinolaryngol 2019 15;82:39-46. Epub 2019 Jan 15.

The human vestibular system is exquisitely sensitive to detect linear and rotational head acceleration signals, processed in the brainstem and subsequently relayed to the extraocular motor neurons to generate a compensatory eye rotation. This vestibulo-ocular reflex (VOR) ensures clear and stable vision during head rotation, enabling humans to keep gaze on their desired target. In this chapter, we describe the rotary chair - one physiologic measure of the VOR, and the dynamic visual acuity (DVA) test - one behavioral measure of the VOR. Read More

Optom Vis Sci 2019 04;96(4):256-265

Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama.

Significance: Oculomotor tests in concussion commonly show impairment in smooth pursuit and saccadic function. Honing in on the systems likely to be affected by concussion will streamline use of oculomotor function as a supplemental diagnostic and prognostic tool, as well as improve our understanding of the pathophysiology of concussion.

Purpose: This study investigates oculomotor function between concussed and healthy collegiate athletes and determines measurement test-retest reliability of those tools. Read More

Arq Neuropsiquiatr 2019 01;77(1):25-32

Universidade Federal de Santa Maria, Departamento de Fonoaudiologia, Santa Maria, RS, Brasil.

Objective: Changes in postural balance and visual complaints are frequent consequences of stroke. We aimed to investigate the symptoms and the vestibular and oculomotor functions of patients with dizziness post ischemic and hemorrhagic stroke and compare the results among them.

Methods: Fifty patients with dizziness after stroke were evaluated through a clinical anamnesis and computerized vector electronystagmography: calibration of ocular movements, spontaneous nystagmus, semi-spontaneous nystagmus, pendular tracking, optokinetic nystagmus, rotary chair testing, and the caloric test. Read More

Otol Neurotol 2018 12;39(10):1222-1228

Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota.

Objective: To characterize patient tolerance and nonmonetary cost burdens of vestibular testing. Rigorously acquired data are essential for patient counseling and to determine if proposed additions/modifications to current protocols improve quality, experience, and efficiencies of care.

Study Design: Prospective observational study. Read More

Semin Hear 2018 Aug 20;39(3):257-274. Epub 2018 Jul 20.

Department of Audiology, Boys Town National Research Hospital, Omaha, Nebraska.

Quantitative tests of vestibular function include the caloric test, cervical and ocular vestibular evoked myogenic potential (VEMP), rotary chair, and head impulse test, either at the bedside or utilizing video head impulse test (vHIT). The purpose of this article is to provide an overview of how to perform these tests in children, including which tests are recommended based on the child's age and any modifications or considerations that can be made. A variety of clinical measures have been recommended as screening measures for vestibular loss, which will be reviewed. Read More

J Am Acad Audiol 2018 Jul/Aug;29(7):587-595

Department of Rehabilitation Science, University at Buffalo, Buffalo, NY.

Background: When patients are given instructions before vestibular function testing, they are often asked to refrain from ingesting caffeine 24 h before testing. However, research regarding the effects of caffeine on the outcome of vestibular function testing is limited.

Purpose: To evaluate whether the results from rotational chair tests are influenced by caffeine. Read More

Eur J Paediatr Neurol 2018 Jul 30;22(4):667-673. Epub 2018 Mar 30.

Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA; Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA.

Introduction: Migraine variant disorders of childhood include benign paroxysmal torticollis of infancy (BPTI) and benign paroxysmal vertigo of childhood (BPVC). This study aimed to review our experience with BPTI and BPVC and determine the incidence of children transitioning between each of these disorders and to vestibular migraine (VM).

Methods: We retrospectively reviewed the medical records of patients seen at the Balance and Vestibular Program at Boston Children's Hospital between January 2012 and December 2016 who were diagnosed with BPTI, BPVC, and/or VM. Read More

Otol Neurotol 2018 04;39(4):e274-e279

Division of Otology-Neurotology, Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan.

Objective: To describe the electrocochleography (ECochG) findings in patients with bilateral vestibular paresis and sound- and/or pressure-induced horizontal nystagmus.

Design: Retrospective case series.

Setting: Tertiary care center. Read More

Otol Neurotol 2018 02;39(2):e108-e112

Department of Otorhinolaryngology-Head & Neck Surgery.

Objectives: The aim of the study is to evaluate whether horizontal ocular deviation (OD) from MR imaging in the emergency room (ER) reflects vestibular imbalance, by comparing the horizontal OD in patients with acute vestibulopathy to controls.

Study Design: Retrospective review.

Patients And Methods: A total of 69 patients with acute unilateral peripheral vestibulopathy and 30 healthy subjects were included. Read More

J Prosthet Dent 2018 Jun 14;119(6):987-993. Epub 2017 Oct 14.

Professor and Chair, Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa.

Statement Of Problem: A recommended minimum thickness for monolithic zirconia restorations has not been reported. Assessing a proper thickness that has the necessary load-bearing capacity but also conserves dental hard tissues is essential.

Purpose: The purpose of this in vitro study was to evaluate the effect of thickness and surface modifications on monolithic zirconia after simulated masticatory stresses. Read More

Ear Hear 2017 Nov/Dec;38(6):e352-e358

1Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; 2Department of Otolaryngology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; 3Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; 4Department of Psychology, University of Tehran, Tehran, Iran; 5Department of Statistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; 6Department of Audiology, Jondi Shapour University of Medical Sciences, Ahvaz, Iran; and 7Department of Psychology, Shahid Beheshti University, Tehran, Iran.

Objectives: Vestibular dysfunction in childhood can have a major effect on a child's developmental process. Balance function has been reported to be poorer in children with attention deficit and hyperactivity disorder (ADHD) than in their typically developing peers. Due to contradictory available evidence and the paucity of research on vestibular function specifically in children with combined ADHD (cADHD), we designed this aged-matched study to assess vestibular function in children with cADHD. Read More

Otolaryngol Head Neck Surg 2017 02 14;156(2):312-320. Epub 2016 Nov 14.

3 Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.

Objective There is a lack of consensus regarding the indications for vestibular testing in the evaluation of dizziness and balance disorders. Geographic variation in health services utilization is associated with lack of consensus. To understand the variation in current practice, we investigated the patterns of use of vestibular testing and diagnosis codes for dizziness and balance disorders among individuals ≥65 years of age across different regions of the United States. Read More

Brain Inj 2016 ;30(12):1501-1514

a Department of Diagnostic Radiology , Wayne State University School of Medicine , Detroit , MI , USA.

Background: Case reports are presented on four Veterans, aged 29-46 years, who complained of chronic dizziness and/or postural instability following blast exposures. Two of the four individuals were diagnosed with mild traumatic brain injury and three of the four were exposed to multiple blasts. Comprehensive vestibular, balance, gait, audiometry and neuroimaging procedures were used to characterize their injuries. Read More