The study of the vestibular apparatus: how is it carried out, indications, the essence of the procedure

The vestibular apparatus is part of a complex mechanism that provides a person with balance and coordination of movements. It continuously interacts with the skin, visual and nervous system. The study of the vestibular apparatus is required in those cases when a failure occurs in their coordinated work, as a result of which a person loses his balance and ceases to navigate in space.

Vestibular apparatus: concept

The body is a complex system, the development of which is completed by 12-15 years. It is part of the inner ear.

Thanks to the work of the vestibular apparatus, a person is easily oriented in space and maintains the balance of the body even with his eyes closed. When you try to make any movement, system receptors are instantly irritated, sending an impulse to the brain and muscle tissue. At the same time, the image is fixed on the retina. Due to this, the body can take any position and hold it for a long time.

Like any other body system, an equilibrium organ is extremely vulnerable. At the first signs of any disturbance of the vestibular apparatus, it is necessary to immediately contact a therapist or otorhinolaryngologist.

Causes of the disorder

The failure of the normal functioning of the organ may be due to the development of certain diseases or the use of certain medications. Often, disorders of the vestibular apparatus appear as the body ages.

The most common causes of the disorder are:

1. Positional dizziness . Occurs when lifting the head up or turning to the side. By nature, it is strong, but short-lived. Dizziness appears due to a violation of the structure of the receptors. Because of this, incorrect information about the position of the body is sent to the brain. The causes of this condition may be head injuries, diseases of the nervous system, aging.
2. Myocardial labyrinth (one of the structures of the inner ear). It is commonly found in elderly patients. In young people, it appears due to the progression of vascular diseases. Accompanied by sudden loss of hearing and coordination of movements.
3. Vestibular neuronitis. The cause is the herpes virus. The peak incidence occurs in the autumn-spring period.
4. Labyrinthitis. Violation of one of the structures of the inner ear is due to the vital activity of viruses and bacteria.
5. Meniere's disease. Non-purulent disease of the ear. It is characterized by damage and subsequent regeneration of the maze.
6. The disease of "discharge". For example, due to a long stay in a moving vehicle, a person involuntarily sways after exiting it.
7. Other causes: migraine, diseases of the nervous system and musculoskeletal system.

Symptoms

The study of the vestibular apparatus must be carried out with the appearance of the following signs of its violation:

• frequent dizziness;
• sudden loss of balance or a feeling of a possible fall;
• weakness;
• visual impairment;
• loss of orientation in space ;
• panic state of anxiety;
• nausea, vomiting;
• increased heart rate;
• difficulty trying to concentrate.

Often a failure in the system is accompanied by disorders of the gastrointestinal tract.

Indications

The study of the function of the vestibular apparatus is prescribed for:

• frequent bouts of dizziness, accompanied by hearing loss;
• decreased reflex reactions;
• the presence of neoplasms in the brain;
• traumatic brain injury;
• encephalitis;
• meningitis;
• multiple sclerosis;
• degenerative damage to the nervous system.

In addition, a study of the function of the vestibular apparatus for the IHC (military medical commission) and when applying for work associated with increased loads on the organ of equilibrium is required.

Contraindications

Inspection is prohibited in the following cases:

• acute period of head injury;
• in the presence of serious cardiovascular pathologies;
• increased intracranial pressure.

Diagnostics

An important point before the study of the function of the vestibular apparatus is the collection of history. With its help, assumptions are made regarding the cause of the violation and the most suitable examination method is selected.

The doctor pays particular attention to the following:

• when symptoms arose, their frequency and duration;
• the nature of the signs, the sequence of their occurrence;
• are there hearing impairments.

Based on the history, the specialist prescribes the most sparing test method. By his decision, the patient can be redirected to other doctors.

To date, there are many methods for studying the vestibular apparatus. The most common are:

1. Test for spontaneous nystagmus (involuntary contractions of the eye muscles). The presence of this symptom is determined as follows: the patient sits on a chair and fixes his gaze on the index finger of a medical worker located about 30 cm from the patient. The researcher begins to move his finger in different directions. When you move your eyes, nystagmus may appear. It has three degrees: weak, medium and strong.
2. The study of positional nystagmus. It occurs due to circulatory disorders and in some diseases of the cervical spine. To identify positional nystagmus, the patient’s head is given a position that impairs blood flow in the arteries of the spine, and, consequently, in the ear labyrinth.
3. Romberg test . The patient stands up and brings them together. After that, he should stretch his arms forward and close his eyes. Dysfunction of the vestibular apparatus is manifested by the wiggle of the patient or his fall.
4. Pointing test . The patient closes his eyes, after which he is offered to touch the tip of the nose with his finger. In case of violation of coordination of movements, he will not be able to do this.
5. Test with a letter. The patient is seated at the table, given paper and a pen. Then he needs to write a few numbers from top to bottom and from left to right. After that, all actions are repeated, but with eyes closed. The result depends on the angle of deviation of the written numbers from the horizontal and vertical lines.
6. Rotational test. The patient sits in a Barani chair and closes his eyes. After that, the chair begins to rotate. If the function of the vestibular apparatus is not impaired, after 10 uniform turns, nystagmus appears in the direction that is opposite to the circle.
7. Caloric sample. Cold or hot water is drawn into a 100 ml syringe, after which it is poured into the ear canal. During normal operation of the vestibular apparatus, nystagmus will appear after 50 ml of fluid has entered. With dysfunction, a reaction will not follow, even with the injection of a large amount of water (up to 500 ml).
8. Otolithic reaction. The patient sits on a ram’s chair, tilts his body forward and closes his eyes. The chair begins to intensively rotate in different directions and abruptly stop. The patient should straighten the body and open his eyes. The nature of the reaction determines the degree of violation. With this method of studying the vestibular apparatus, the worst result is a fall, vomiting, fainting.

Where to get an examination of the vestibular apparatus?

Such a diagnosis is carried out by an otorhinolaryngologist. When symptoms of vestibular apparatus dysfunction appear, it is necessary to consult an ENT or a physician who will give an appropriate direction. The procedure can also be carried out on a contractual basis by contacting a private clinic.

Finally

The vestibular apparatus is a complex mechanism that provides a person with balance and the ability to navigate in space. It is closely associated with other bodies. If the system malfunctions, unpleasant symptoms appear. When they occur, a study of the vestibular apparatus by an otorhinolaryngologist is indicated.