What preliminary technical steps must be followed before VNG?
Answer
A series of preliminary technical steps must be followed before proceeding to perform a VNG exam. Among these, the fundamental moment is that of positioning the goggles.
It is necessary to note:
The visibility and regularity of the pupillary contour. The latter can be partially hidden by an eyelid ptosis and/or by the projection of the eyelashes. Furthermore, the patient may tend to keep his eyes half closed, sometimes even just because of an incorrect pitch of the head;
To the sources of black present in the image of the eye that are competitive with the pupillary area: eyelashes, tear film between eyelids and cornea, inhomogeneity of the dioptric media and periocular shadow areas;
To the attitude of the head that must not present incorrect rotations in the yaw, pitch and roll axes;
To the infiltration of light along the contour of the goggles that comes into contact with the face;
To the comfort with which the goggles are worn.
If one or more of the aforementioned conditions occur, it is advisable to correct them in order to obtain a pupillary contour as precise and stable as possible. Among the technical devices useful for this purpose, we can mention the patching of the eyelids, the application of white mascara on the eyelashes, the modification of the pitch angle of the head, and the variation of the grey scale with which the recorded image of the eye.
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.
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