Hearing and Balance Unit

It is a set of tests that evaluate balance organs, brain and cerebellum functions by measuring eye and head movements by wearing glasses with a computer system and a camera on the eye with a special device.

It is important to determine the lesion side and location in all patients presenting with dizziness (vertigo), feeling of imbalance (dizziness), feeling of drowsiness (unsteadiness) or ataxia.

VNG Tests Consist of These Subtitles:

• -Gaze Tests: It is performed to determine the presence of eye beats (nystagmus) during a visual stimulus.
• -Skew Deviation tests
• -Head Shaking Test: The test, which is performed by closing the test glasses (goggle) on the patient’s eyes, is performed by the audiologist by shaking the patient’s head to the right and left at the same speed. The clinician asks the patient to stop the nodding and not close their eyes. The resulting eye beats (nystagmus) help us in the diagnosis of patients with peripheral vestibular dysfunction.
• -Spontaneous Nystagmus Test: It is one of the important signs of vestibular dysfunction. In this test, the goggle attached to the patient is closed. Spontaneous blinks in the dark without any visual stimuli. It helps us in the diagnosis of patients with peripheral vestibular dysfunction.
• -Saccade Test: It is used to show the adaptation of the Central Nervous System to rapid eye movements.
• -VVOR and VORS Tests are available.

VNG tests specifically answer the question of whether the disease originates from the inner ear or the central nervous system (cerebellum).

It is a test that evaluates each of the 6 semicircular canals in the inner ear balance organ and the associated vestibulo-ocular reflex (vor). In case of weakness in any channel, it shows us this and leads us to the correct diagnosis and treatment.

Some diagnostic tests are used in the disease, especially BPPV, which is known as crystal shift among the people. These are below.

1- Dix-Hallpike Test: This test is used as a differential diagnosis in patients with Posterior SCC BPPV.

2-Side-Lying Test: This test is used as a differential diagnosis in patients with Posterior SCC BPPV who have difficulty in performing head-neck movements.

3- Supine Head Roll Test: This test is used as a differential diagnosis in patients with Lateral SCC BPPV.

4- Straight-Back Head Hanging Test: This test is used as a differential diagnosis in patients with anterior SCC BPPV.

Vestibular Rehabilitation (Balance Physical Therapy):

Vestibular rehabilitation; It is a simple, low-cost, and cost-effective solution used to improve balance control and quality of life in patients with weakness in the vestibular organs (vestibular neuronitis, vestibular migraine, etc.), support visual stabilization with head movements, improve vestibular-visual interaction during head movement, and expand static and dynamic posture stability. It is an effective treatment method. Treatment is usually 10-14 sessions 3 times a week every other day. A patient-specific program is created and includes exercises that are completely suitable for the patient’s condition.

Vestibular Rehabilitation

• **Patients with vertigo and balance disorders originating from the inner ear, that is, due to balance organ damage (Meniere’s disease, vestibular neuronitis, labyrinthitis, etc.)
• **For vestibular migraine patients
• **For patients with crystal play that does not improve despite maneuvers
• **Patients with unexplained imbalance complaints
• **Age related imbalance problem
• **Imbalance problem that develops after brain surgeries
• **Applied to patients with phobic vestibular vertigo.

It is based on the use of pure tones in the evaluation of individuals’ hearing. With pure tone audiometry, speech tests and free field tests and silent room in our clinic, we can accurately identify hearing loss and reach the right diagnosis and treatment.

Free field audiometry, which is limited in number in Antalya, is also available in our clinic. With free field audiometry, we determine the benefit of hearing aid patients with hearing aids.

Although we determine pure tone thresholds and hearing thresholds, this is not entirely sufficient. Speech audiometry in our clinic provides us with very valuable information on pathologies in the middle ear, cochlea, auditory nerve, central auditory system and auditory pathways.

One of the subtests in speech audiometry is the irritating sound level determination test.

The disturbing sound level test provides us with important information about where the existing loss originates.

It is a test used to determine hearing thresholds in adults, children or infants, who are seated on a table in the midline in a silent cabinet, as a result of the sound being given from the right and left speakers. In addition to determining hearing thresholds in children and infants, it is also used in individuals with hearing aids or implants.

It is generally used in infants (0-4 months). The baby’s hearing thresholds are determined by the audiologist by looking at the baby’s behavioral responses (blinking, head turning, hand and foot movements, crying and sucking reflex) by sending pure tone stimuli, speech stimuli and various noises to the baby in the Free Space.

It is generally applied in infants and children (5-24 months). Free Space or headphones are used. The child is seated so that he can see both sides. There are light boxes and moving toys on the right and left. During the test, an audiologist should play with the child and keep the child’s attention. Then, hearing thresholds are determined by monitoring the child’s reaction with the sounds sent to visual stimuli.

It is generally used in children (24 months and later). The test is administered in Free Space or with headphones. A headset is put on the child and blocks or toys are placed in front of him. The child is conditioned to listen to the lego whenever a sound is heard and to throw the lego into the box after hearing the sound. In this way, the hearing thresholds of the child are determined.

Tympanometry in our clinic; It is a test that detects the presence of fluid in the middle ear or movement disorders in the ossicular system by measuring the middle ear pressure, and also helps to detect middle ear air-pressure and Eustachian tube problems. It is frequently used for ear problems in children.

Regulatory cells in the inner ear are tests that give us detailed and objective information about the function of the auditory nerve and facial nerve. It is also used in the objective evaluation of hearing in children and infants.