Search Our Scientific Publications & Authors

Pediatrics 2021 Feb 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

Otolaryngol Head Neck Surg 2016 07;155(1):42-7

Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.

Objective: We used a national otolaryngology practice-based research network database to characterize the utilization of vestibular function testing in patients diagnosed with dizziness and/or a vestibular disorder.

Study Design: Database review.

Setting: The Creating Healthcare Excellence through Education and Research (CHEER) practice-based research network of academic and community providers

Subjects And Methods: Dizzy patients in the CHEER retrospective database were identified through ICD-9 codes; vestibular testing procedures were identified with CPT codes. Read More

J Prosthet Dent 2016 Oct 5;116(4):558-563. Epub 2016 May 5.

Professor, Chair and Program Director, Division of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY.

Statement Of Problem: Laboratory studies of tooth preparation often involve single values for all variables other than the one being tested. In contrast, in clinical settings, not all variables can be adequately controlled. For example, a new dental rotary cutting instrument may be tested in the laboratory by making a specific cut with a fixed force, but, in clinical practice, the instrument must make different cuts with individual dentists applying different forces. Read More

Int J Pediatr Otorhinolaryngol 2016 Apr 1;83:104-8. Epub 2016 Feb 1.

Department of Otolaryngology and Communication Enhancement (J.R.B., B.A.C., GW.Z.), Boston Children's Hospital, Boston, MA, USA; Department of Otology and Laryngology (J.R.B., GW.Z.), Harvard Medical School, Boston, MA, USA.

Objective: Describe the clinical presentation and recovery of vestibular neuritis in children and adolescents.

Study Design: Retrospective case series.

Setting: Pediatric tertiary care center. Read More

Audiol Res 2015 Jan 9;5(1):120. Epub 2015 Mar 9.

Cleveland Clinic , USA.

Enlarged vestibular aqueduct (EVA) is one of the commonly identified congenital temporal bone abnormalities associated with sensorineural hearing loss. Hearing loss may be unilateral or bilateral, and typically presents at birth or in early childhood. Vestibular symptoms have been reported in up to 50% of affected individuals, and may be delayed in onset until adulthood. Read More

Eur J Paediatr Neurol 2016 Jan 22;20(1):85-92. Epub 2015 Oct 22.

Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA.

Objective: Epidemiologic studies have shown Vestibular migraine (VM) to be the most common cause of vertigo in children, but little is known about the typical presentation and response to treatment of this disorder in the pediatric population. The aim of this study was to evaluate the diagnostic features and response to therapy of VM in children managed at a pediatric vestibular clinic.

Methods: Twenty-eight patients ≤18 years old with a diagnosis of VM were identified from 208 patients seen at the Balance and Vestibular Program at Boston Children's Hospital from July 2012-July 2014, after excluding 12 patients with a history of major otologic or neurologic surgery, recent concussion, or additional vestibular disorders. Read More

Laryngoscope 2016 Feb 30;126(2):460-3. Epub 2015 Jul 30.

Department of Otolaryngology, New York Eye and Ear Infirmary of Mount Sinai, New York, U.S.A.

Objectives/hypothesis: The purpose of this study is to examine the range of vestibulo-ocular reflex (VOR) gain on rotary chair (RC) testing in subjects without ear and vestibular problems stratified by age and gender.

Study Design: Prospective cross-sectional study.

Methods: One hundred subjects ranging in age from 6 to 78 years underwent RC testing. Read More

Int J Pediatr Otorhinolaryngol 2015 Aug 29;79(8):1283-7. Epub 2015 May 29.

The Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; The Department of Otology and Laryngology, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA. Electronic address:

Objectives: VHIT is the first vestibular test to evaluate all six semicircular canals. This test has advantages over the rotary chair and caloric tests in evaluating children since it does not require fear-inducing darkness or provocation of dizziness. The goal of this study was to review our initial experience with VHIT in children and adolescents at a pediatric vestibular program. Read More