New visitors to the Gebbie Speech, Language and Hearing Clinic in the Department of Communication Sciences and Disorders sometimes don’t even notice the new videonystagmography (VNG) system when they enter the room. exam. This is understandable, because its unobtrusive presence on a countertop suggests nothing more complicated than a printer. They would stop for a bit, however, if they knew how important this equipment is to the patients and students who learn in this center.
The VNG system was made possible by a donation made last year by Whitman alumnus George Knight ’81 in honor of his late wife Kimberly, who received a master’s degree in audiology from the University in 1982 State-of-the-art equipment – perhaps the only one of its kind in central New York – also includes a 60-inch wall monitor, essential for teaching purposes, and a motorized examination table that allows for positioning. patients tested – not only for comfort, but crucial, as the different positions are part of diagnostic examinations.
“We are very grateful to George Knight, who has made generous donations to the Gebbie Clinic for years in memory of his wife, Kimberly,” said Kathy Vander Werff, professor of audiology and chair of the Department of Human Sciences and Disorders. Communication. âHe reached out because he wanted to make a bigger donation that would really benefit our clinic. He’s been tremendously supportive, and we’ve really expanded our services and the way we can train our students accordingly.
The Gebbie Clinic opened in 1972 as a research center in communication sciences and disorders. The clinic provides service to the central New York City community while training graduate students enrolled in audiology and speech-language pathology programs. The new VNG system highlights the advanced diagnostic and treatment services offered by the Gebbie Clinic to the community that are not widely available in the area.
The VNG equipment performs a series of diagnostic tests of the vestibular system, the parts of the inner ear responsible for balance. Interestingly, the first thing a patient undergoing a vestibular test does is put on a pair of protective glasses, which displays an image of their eyes on the monitor.
Wait: eyes? For inner ear tests?
âBalance has to do with integrating sensory inputs from the eyes, ears, muscles and joints,â says Vander Werff. âWe can’t see the inner ear directly, but we can have a window into how the visual and vestibular systems work together. “
Many patients who visit a hearing clinic are not there because of hearing problems, but because of dizziness.
âDizziness is the number one complaint in a primary care physician’s office for the elderly, and if you look at all ages, it’s one of the three most common complaints. It’s an expense for the medical system and a serious social problem, âsays audiologist Stefania Arduini, Au.D., who performs vestibular diagnostic tests at the Gebbie clinic and teaches a vestibular audiology course to students. of the clinical doctor of audiology program in the department.
According to Arduini, dizziness leads to falls. For an elderly patient with a problem with a falling ear and a broken hip, it can be very difficult to bounce back.
âWith this equipment, we can perform eye motor tests that look at eye movements,â says Arduini. âWe can test positional dizziness, dizziness that occurs in certain positions. Some people have a crystal problem, where a crystal dislodges in the ear; we can test and then deal with this problem. Finally, we have the benchmark test that has stood the test of time, the Calorie Test (response to heat or cold), which examines weaknesses in the semicircular canals of the inner ear, another main cause of fear of heights. All of these tests can be done with this new equipment.
The new VNG system replaces obsolete equipment and has enabled the clinic to expand its diagnostic services and educational possibilities. This current system can be connected to other existing equipment making it a full test battery and the new monitor means a room full of students can watch every step.
Arduini demonstrates one of the tests his patients could undergo. His volunteer puts on a pair of glasses and his eyes suddenly appear on the monitor, huge and slightly supernatural, due to the projection that pulls the nose out and positions the eyes directly next to each other. A dot appears on the screen and the volunteer is invited to follow it with her eyes as it bounces like a rubber ball on a squash court. Meanwhile, Arduini looks at the computer to trace eye movements. âWith this particular test, we are looking for information about how the central nervous system is functioning,â she says. Students watching this exam could clearly see all moving parts, due to the size of the monitor.
They undergo an optokinetic test, which examines the peripheral and central vestibular systems. While the screen represents a cartoon of a village moving horizontally, as in a video game like Super Mario Brothers, the volunteers’ eyes scrutinize the movement of the scene.
Next is a test that covers a patient’s eyes and leaves them in the dark, although the computer is still able to watch and record eye behavior. âI’m looking for particular eye movements with no stimulus present,â explains Arduini. “Sometimes if someone is having trouble with balance or dizziness, particular eye movements can give us more information on whether it’s coming from the ears versus the central nervous system.”
âBefore that, if you saw a patient who you thought might benefit from this test, you had to refer them elsewhere,â says Vander Werff. Unfortunately, many patients who do not have access to a clinic like Gebbie never receive this referral.
âDoctors will often assume that a patient has some form of vertigo when in fact it’s something completely different,â says Arduini. âWhat I see all the time are patients who come in years later saying, ‘I did this thing and it doesn’t work. There are co-payments, therapies, even if they don’t have a formal diagnosis.
It is not uncommon for patients, when finally seen at Gebbie’s, to find they have a completely different problem than the one they were treating. “We have had patients who were told that there was nothing to be done for their vertigo for 20 years, when in fact they are candidates for vestibular rehabilitation,” says Arduini. âI myself am a dizzy patient. I know the importance of getting a proper diagnosis.
As if the VNG system didn’t already seem miraculous, it also constantly adapts to new research and allows software to be upgraded with the very latest testing capabilities as they emerge in the field.
âWith this equipment, as well as the other tests we offer, we can fully assess our dizzy patients. Few clinics in this region can do this. I am extremely proud of it, âsays Arduini.