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Dizziness

Indications for Caloric Testing


Caloric testing refers to cold and warm water irrigation of the external ear canals, resulting in movement of the eyes. Measurements of the speed of eye movement provide information about the sensitivity of the inner ear balance mechanisms on each side.
 

Indications for Caloric Testing

• to confirm that dizziness is of inner ear origin
• to provide the patient with understanding and reassurance of a definite diagnosis
• to more confidently provide a specific treatment with vestibular rehabilitation

65% of patients with vestibular symptoms have abnormal caloric tests. 
Most commonly, isolated vestibular dizziness originates in the inner ear rather than in the brain. 
 

Advantages of Caloric Testing

  • the stimulus is easily administered
  • the stimulus is well tolerated by most patients
  • separate testing provides information about each ear
 

Disadvantages of Caloric Testing

  • produces nausea in a small proportion (5%)
  • cannot be performed with a tympanic perforation (hole in the ear drum)
  • reduced responsiveness with middle ear fluid congestion