Videonystromagraphy (VNG) Testing
The assessment and the tests are carried out by Vitaly Kisilevsky, an international medical graduate specializing in otolaryngology (ENT). Vitaly Kisilevsky completed a clinical and research fellowship at U of T in medical neurotology and otology. Currently, his focus is conducting Neuro-Physiological Vestibular Evaluations. His assessment of MVA clients provides objective evidence of traumatic damage to the balance system and is relevant to cases of head and neck trauma, musculo-skeletal and neural system injuries and post-traumatic disorders.
A VNG tests the oculo-motor, positional and caloric responses of patient’s inner ear. The test is looking to determine if vestibular disease is affecting the inner ear which may be causing the patient to feel unbalanced or dizzy. VNG Testing is non-invasive and the safest, most accurate and most comfortable way to test for Vestibular Disease. Additionally, this is the gold standard test that can differentiate which ear the disease is affecting.
Description of Test
This is a four-part test that should take up to 45 minutes to complete.
The first part, patients will be asked to follow a moving object with their eyes. Eyes movements will be evaluated for slowness or inaccuracies following moving objects.
The second part of the test, patients will be asked to follow a large, fast moving objects while eyes movements will be evaluated for asymmetry or imbalance.
The next part of the test, the doctor will move patient’s head in various directions looking to see if there are any abnormal eye movements in different head and body positions.
The final stage of the test involves stimulating patient’s ears by using air caloric stimulation and tracking eye movement while ears are stimulated. This will help determine which ear is being affected by vestibular disease.
This is a completely safe and non-invasive test.
Inner Ear Testing (ABR, ECochG and VEMP)
Inner Ear testing will be carried out by JY Lee Choi. JY Choi graduated with a Doctor of Audiology from University of Florida in USA. She is also the American Board Certified Audiologist and has performed vestibular function testing at Toronto Western Hospital and electrophysiological measures at Toronto Eastern Hospital. She is a fellow of the American Academy of Audiology (FAAA) and holds the ASHA(American Speech-Language-Hearing Association), Certificate of Clinical Competence in Audiology (CCC-A), and is registered with CASLPO (College of Audiologists and Speech-Language Pathologists of Ontario).
Consultations for dizzy patients in addition to general otolaryngology (Ear Nose and Throat) will be carried out by Dr. Xerxes Punthakee MD, FRCSC who completed medical school and residency at the University of Toronto, and is a licensed specialist in Otolaryngology, Head and Neck Surgery.
Description of Test
Auditory Brainstem Response (ABR)
The electrodes are placed on the forehead and ears, and the click stimulus is delivered by earphones. The test records the electrical activity from the auditory pathway. You do not need to respond to sounds and are required to sit relaxed with your eyes closed.
The electrodes are placed on the forehead, behind both ears, and a flexible non invasive TM electrode should be inserted deep in your ear canals. Then the click stimulus is presented through the earphones. The test records the electrical activity from the inner ear. You do not need to respond to sounds and are required to sit relaxed with your eyes closed.
Vestibular Evoked Myogenic Potential (oVEMP)
The electrodes are placed under the eyes, the forehead, and the chin. The click stimulus is presented through the earphones. Then you are asked to look slightly upward and the machine will record the electrical potentials.
Vestibular Evoked Myogenic Potential (cVEMP)
The electrodes are placed on the forehead, behind both ears and on the contracted neck muscle with the patient turning his head sharply in the opposite direction of the stimulated ear. The click stimulus is presented through ear phones.