Vestibular Issues And Balance Disorders CEU Courses

Besides typical symptoms and signs (including pulsatile tinnitus, hyperacusis, pressure/sound-induced torsional nystagmus, conductive hearing loss and lowered thresholds of air-conducted VEMPs) an analysis of the relevant literature reveals a certain clinical polymorphism induced by superior canal dehiscence (SCD). In addition to asymptomatic persons or subjects with SCD presenting exclusively with cochlear symptoms (only partly explained by the so-called “near-dehiscence syndrome”), SCD cases mainly presenting with atypical/refractory/recurrent positional vertigo and/or Meniere-like vertigo spells have been recently described. Moreover, if surgical occlusion of the superior canal (SC) results in symptoms control inducing a selective SC hypofunction, clinicians my sometimes accidentally detect a reduced SC VOR gain in asymptomatic patients with wide-sized dehiscence. These findings led authors to propose the occurrence either of a natural SC plugging (complete or incomplete) by middle fossa dura prolapsing into the canal lumen or a dispersion of mechanical energy through the dehiscence. Typical and atypical scenarios is presented. A subsample of patients from the personal series with a complete otoneurologic assessment (audiometry, VOG eye recording, air/bone-conducted cervical/ocular VEMPs, video head impulse test) is selected to explain these emerging theories on possible pathomechanisms.

This presentation will cover higher level vestibular functions that normally are not addressed in training. These areas included the effect of age and pathology on motion perception.

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.

Experienced providers from Michigan Medicine will detail the patient journey from identification through intervention for vestibular schwannomas. This series will provide an overview of diagnostic auditory and vestibular evaluations relevant to vestibular schwannomas, medical and surgical management of these tumors from the perspective of a neurotologist, as well as intraoperative monitoring considerations.

This course will provide an overview of the techniques used to monitor hearing and facial nerve during vestibular schwannoma surgeries. Particular attention will be paid to monitoring and outcomes for hearing preservation surgeries.

This course reviews the common symptoms and findings associated with vestibular schwannoma, as well as workup and differential diagnosis for lesions of the cerebellopontine angle. A discussion of the natural history of vestibular schwannoma and general current paradigms for treatment are included.

This course is the first in a 3-part series hosted by presenters from Michigan Medicine detailing the evaluation and management of vestibular schwannomas. In this course, we will present an overview of pre-operative diagnostic evaluations performed by audiologists to evaluate the status of auditory, vestibular and facial nerve function in patients with vestibular schwannomas.

This course will discuss diagnostic criteria for vestibular migraines and cover the diagnosis, treatment, and management of vestibular migraines.

Meniere's Disease (MD) is one of the most intriguing and somewhat frustrating pathologies that, over the more than 150 years since its first description, has kept scientists and dedicated professionals busy searching for any development that would be helpful in curing affected patients. Histopathological studies have associated MD with the accumulation of endolymph in the cochlea and the vestibular organs. However, there are several comorbidities associated with MD, such as migraine, anxiety, autoimmune, and autoinflammatory disorders, which add more complexity to the phenotype. The goal of this lecture is to explain the approach to the diagnosis and treatment of MD, highlighting the importance of non-ablative therapy options and discussing treatment protocols after medical failure.

The purpose of this course is to provide an in-depth discussion of the caloric testing portion of the VNG/ENG test battery. Content will include descriptions of testing procedures, analysis and interpretation of results.