Clarke Andrew H
Vestibular Research Laboratory, Charité Medical School, Berlin, Germany.
Curr Opin Otolaryngol Head Neck Surg. 2010 Oct;18(5):425-30. doi: 10.1097/MOO.0b013e32833de137.
Recent reports on vestibular testing, relevant to clinical diagnosis, are reviewed.Besides the case history and bedside examination, objective measurement of the vestibuloocular reflex in all of its facets remains the cornerstone in the diagnostic process.
In recent years, this has been enhanced considerably by reliable unilateral tests for the otolith organs, most notably by vestibular-evoked myogenic potential recording and estimation of subjective visual vertical. In addition, progress has been made in the investigation of multisensory interaction, involving visual acuity and posturography.Technological developments include improved eye movement measurement techniques, electrotactile and vibrotactile sensory enhancement or substitution, the use of virtual reality devices and motion stimulators such as hexapods and the rediscovery of galvanic vestibular stimulation as a research and diagnostic tool.
The recent introduction of new tests, together with the development of novel technologies, is gradually increasing the scope of the physical and bedside examination of the dizzy patient (see chapter 'Medical management of peripheral disorders' in this issue). The use of more complex equipment, such as rotating chairs, linear sleds, hexapods and posturography platforms, is likely to become limited to specialized laboratories and rehabilitation centers in future years. Further, high resolution magnetic resonance tomography (MRT) and computed tomography have allowed insight into the morphology and determination of malformations of the human labyrinth.
对近期与临床诊断相关的前庭测试报告进行综述。除了病史和床边检查外，全面客观地测量前庭眼反射仍是诊断过程的基石。
近年来，耳石器官的可靠单侧测试极大地推动了这一领域的发展，最显著的是前庭诱发肌源性电位记录和主观视觉垂直线估计。此外，在涉及视力和姿势描记法的多感官相互作用研究方面也取得了进展。技术发展包括改进的眼动测量技术、电触觉和振动触觉感觉增强或替代、虚拟现实设备和运动刺激器（如六足平台）的使用，以及将 galvanic 前庭刺激重新用作研究和诊断工具。
新测试的近期引入以及新技术的发展正在逐渐扩大对头晕患者进行体格检查和床边检查的范围（见本期“周围性疾病的医学管理”一章）。未来几年，旋转椅、线性雪橇、六足平台和姿势描记平台等更复杂设备的使用可能会局限于专业实验室和康复中心。此外，高分辨率磁共振断层扫描（MRT）和计算机断层扫描使人们能够深入了解人类迷路的形态并确定畸形情况。
