Taking vestibular testing outside of the clinic: Part II
In June 2023, with the support of the William Demant Foundation, Dr. Daniel Romero and audiology students from Vanderbilt University Medical Center (VUMC) embarked on a mission trip to Kraków, Poland to provide hearing and vestibular services to Ukrainian refugees.
Read more: Taking vestibular testing outside of the clinic
In November 2023, the group completed a second visit to provide services to a new group of refugees with primary complaints of dizziness and imbalance. The team also utilized this trip to follow up with patients originally evaluated in June.
Given that most patients tested this time around reported active symptoms of dizziness and/or imbalance, the team wanted to improve the vestibular testing protocol as well as make improvements to the patient handouts with the assistance of a physical therapist and collaborator, Dr. Holly Cauthen, PT, DPT.
The team was able to bring the portable EyeSeeCam vHIT system with the assistance of Interacoustics.
The inclusion of vHIT was ideal since it allowed more objective assessment of peripheral vestibular impairment and could be used in conjunction with the VisualEyes™ video goggles and software the team used in prior assessment. In addition to improvements to the testing protocol, the team also incorporated goal-oriented therapy to make handing out vestibular exercises simple, yet challenging and easy to follow to ensure patient understanding.
In the November trip, the team assessed 35 patients with a mean age of 60 years (SD = 12.6 years; 33 female). See overall findings of suspected cases in Table 1.
| Vestibular impairment | Percentage of patients |
| Imbalance | 40% |
| Peripheral vestibular impairment | 29% |
| Vestibular migraine | 26% |
| Central involvement | 23% |
| BPPV | 11% |
| Unspecified | 9% |
| PPPD | 3% |
Table 1: Vestibular impairments identified in the 35 patients.
Furthermore, they were able to follow up with patients tested in June. Most patients reported improvement in their symptoms while other still reported dizziness. In anticipation of this, the team provided more challenging exercises to increase the success of vestibular compensation. Further follow ups with these patients are expected to take place over the next few months.
Overall, there is strong evidence for a need of vestibular testing for those who currently do not have access to it including other international and domestic communities. While currently an incomplete vestibular evaluation, this trip helps support that testing is possible and feasible.
About the authors
Dr. Daniel Romero, Au.D., Ph.D., is a Postdoctoral Research Fellow at Vanderbilt University Medical Center (VUMC). He earned his Au.D. in 2018 from Northern Illinois University after which he took his Ph.D. at James Madison University.
Dr. Liz Fuemmeler, Au.D., is a Clinical Product Manager with Interacoustics and Vestibular Program Director at Professional Hearing Center in Kansas City, MO.
