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A Guide to Bithermal Caloric Testing

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1.  What is the correct angle for the head when the patient is positioned for caloric testing? 30 degrees inclined 15 degrees hanging 45 degrees inclined 15 degrees inclined

2.  Which of the following accurately defines the COWS acronym? Cold Open Warm Shut Cold October Warm September Cold Opposite Warm Same Cold Onions Warm Sausage

3.  Which of the following is used to calculate directional preponderance (DP)? Total right ear response minus total left ear response divided by the total of all responses Total right-beating response minus total left-beating response divided by the total of all responses Total warm irrigation response minus total cold irrigation response divided by the total of all responses Right warm response minus left warm response divided by the total warm responses

4.  Which of the following is used to calculate unilateral weakness (UW)? Total right ear response minus total left ear response divided by the total of all responses Total right-beating response minus total left-beating response divided by the total of all responses Total warm irrigation response minus total cold irrigation response divided by the total of all responses Right warm response minus left warm response divided by the total warm responses

5.  When should you start alerting or tasking the patient during caloric testing? At the onset of the caloric irrigation Never After the irrigation is completed 20-30 seconds into the irrigation

6.  Which of the following is used to calculate temperature effect (TE)? Total right ear response minus total left ear response divided by the total of all responses Total right-beating response minus total left-beating response divided by the total of all responses Total warm irrigation response minus total cold irrigation response divided by the total of all responses Right warm response minus left warm response divided by the total warm responses

7.  What is the difference between gain asymmetry and directional preponderance? Gain asymmetry takes into account the temperature effect and directional preponderance does not Gain asymmetry takes into account the unilateral weakness and directional preponderance does not Gain asymmetry takes into account the calibration of the tracing and directional preponderance does not Gain asymmetry takes into account the baseline shift and directional preponderance does not

8.  When would you shift the baseline in your caloric analysis? Whenever you feel like it When a spontaneous nystagmus has biased the caloric responses to have a midpoint away from zero When a temperature effect exists When a central pathology exists

9.  How do you find the correct temperatures and flow rate for your irrigator? Look at your User Manual Use 44 degrees Celsius for warm, 30 degrees Celsius for cool, 8 LPM Use the recommended settings from the ANSI standard Use 50 degrees Celsius for warm, 24 degrees Celsius for cool, 8 LPM

10.  Which of the following is the best way to test an ear with a perforated eardrum? The same way you would test an ear without a perforated eardrum Get an ENT's clearance to irrigate, irrigate with water only, irrigate a short time, and do not compare results between ears Get an ENT's clearance to irrigate, irrigate with air only, irrigate a short time, and do not compare results between ears Do not perform calorics on a patient with a perforated eardrum