AudiologyOnline Phone: 800-753-2160


Inventis - June 2021

What are the Fundamental Rules When Performing a vHIT?

Enrico Armato, MD

March 21, 2022

Share:

Question

What are the fundamental rules when performing a vHIT?

Answer

Here are some simple but fundamental rules to perform a vHIT:

Environmental Setup

  • Darkness is not mandatory
  • Small target is easily visible
  • Use a room with LED or fluorescent lighting
  • No direct sunlight
  • Use a solid chair without wheels and with a sufficiently high back but does not prevent the examiner's maneuvers

  • Place the target on the wall so that the patient eye – target distance is > 150/200 cm (only for patient eye – target distances > 150/200 cm, eye rotations are equal (right = left) and equal to head rotation); the gain calculation can be wrong (hyper gain) for shorter distance

Patient Instructions

  • Look carefully at the target on the wall 
  • Always keep the eyes wide open, especially while performing the movement (partial closure should also be avoided)
  • If at the end of the movement, the patient realizes that the gaze is no longer on the target, they must move their eyes to regain immediately
  • Keep the neck as soft as possible and do not oppose and/or contribute to the movement
  • Keep the back straight and in contact with the seatback (frequent tendency to anteropulsion of the head and trunk during the examination)

Execution of The Test

  • Before starting the test, check conjugation and amplitude of eye movements
  • Initially, move the patient's head slowly in the examination field to make the patient understand the direction and amplitude of the movements
  • Perform high acceleration maneuvers but with limited amplitude (ideal <10-15°).
  • Avoid the head bounce: you must stop at the end of the movement and do not immediately return to the initial position
  • During the movement the pupil must not go beyond the region of interest (ROI); otherwise that impulse will not be valid
  • Prevent hair from being present in the examination field
  • Wearing latex gloves can improve the grip of the patient's head

Warning

  • Mascara (usually does not interfere too much, but it is better to avoid it)
  • Crystalline prosthesis (parasitic reflexes)
  • Tear films on the free edge of the lower eyelid (parasitic reflexes)
  • Patient distraction can lead to tests burdened with heavy artifacts

 

To learn more about Inventis please visit their Corporate Partner page on AudiologyOnline or inventis.it


enrico armato

Enrico Armato, MD

ENT, AULSS 3 Regione Veneto, (Venice, Italy)

Enrico received his specialization in Medicine and Surgery from Padua University. He subsequently obtained an ENT specialization and another specialization in Audiology. He has over 25 years of experience working as an ENT specialist focused on surgery, especially in the neck area. His real passion is Otoneurology. For many years he has been interested in the functional evaluation of vertiginous patients. He has presented at various webinar and meetings both nationally and internationally.

He is the author of the book The Video Head Impulse Test – Theoretical and practical aspects and co-author of several journal articles and book chapters in national and international literature. He is engaged in performing diagnostic vestibular testing with all age ranges in various practice environments. 


Related Courses

REM Workshop Part 1: Scientific Principles Underlying the Common Verification Techniques
Presented by Jay Jindal, AuD, Nicole DaRocha
Recorded Webinar
INVENTIS • Audiology & Balance Equipment

Presenters

Jay Jindal, AuDNicole DaRocha
Course: #37137Level: Intermediate2.5 Hours
  'Excellent course'   Read Reviews
A complete, practical course in the verification of hearing device fittings. Our experts will cover all clinically important aspects of real-ear measurements, which is an excellent initial reference point for the hearing care professional and his clients to start the journey of better hearing. In this 1st session, the speakers will talk about the scientific principles underlying the common verification techniques.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $99/yr

Learn More

REM Workshop Part 2: Setting Up and Verifying Various Fitting Parameters via Real Ear Measurements
Presented by Jay Jindal, AuD, Nicole DaRocha
Recorded Webinar
INVENTIS • Audiology & Balance Equipment

Presenters

Jay Jindal, AuDNicole DaRocha
Course: #37143Level: Intermediate2.5 Hours
  'Practical application'   Read Reviews
A complete, practical course in the verification of hearing device fittings. Our experts will cover all clinically important aspects of real-ear measurements, which is an excellent initial reference point for the hearing care professional and his clients to start the journey of better hearing. This 2nd session covers the setting and verification of the various fitting parameters via real-ear measurements.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $99/yr

Learn More

Vestibular and Balance Assessment in Children with Sensorineural Hearing Loss: An Overview
Presented by Nor Haniza Abdul Wahat, PhD
Recorded Webinar
INVENTIS • Audiology & Balance Equipment

Presenter

Nor Haniza Abdul Wahat, PhD
Course: #36958Level: Intermediate1 Hour
  'Challenge to understand presenter due to her accent'   Read Reviews
Over the past five years, we have seen a growing interest in studying vestibular disorders in children. The most commonly noteworthy are vestibular disorders in congenital sensorineural hearing loss (SNHL) and cochlear implants. Identifying and diagnosing vestibular and balance dysfunction in children is essential for their overall well-being. However, the diagnosis process is very demanding.This talk will provide an overview of vestibular and balance assessments in children with SNHL.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $99/yr

Learn More

Symphonia - the Software for Virtual Sound Environment Creation
Presented by Michele Buonocore, AuD
Recorded Webinar
INVENTIS • Audiology & Balance Equipment

Presenter

Michele Buonocore, AuD
Course: #37727Level: Introductory0.75 Hours
This webinar reviews the Symphonia system, which enables hearing care professionals to simulate real-world listening scenes so that patients can experience the benefits of hearing aids and advanced hearing aid features. Symphonia provides 360° directional sound sources and allows the professional to change the angle and distance from which sounds are perceived by the patient in real-time.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $99/yr

Learn More

Real-Time Diagnostic Tele-Audiology: The Future is Now!
Presented by Elizabeth Thompson, AuD
Recorded Webinar
INVENTIS • Audiology & Balance Equipment

Presenter

Elizabeth Thompson, AuD
Course: #37019Level: Intermediate1 Hour
  'Great cutting edge info!!'   Read Reviews
The need for real-time diagnostic tele-audiology solutions continues to grow as the demand for audiology services expands. This course discusses the benefits of tele-audiology, the opportunities for use and how Satellite by Inventis is uniquely positioned to deliver by providing tools that allow providers to interact and perform complete hearing assessments remotely in real-time.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $99/yr

Learn More

Our site uses cookies to improve your experience. By using our site, you agree to our Privacy Policy.