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The role of caloric testing in balance system assessment: past, present and future

机译：热量测试在天平系统评估中的作用：过去，现在和将来

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Some 6 years ago, I was given responsibility for the delivery and development of testing for patients with balance disorders at a regional audiology centre. At that time, vestibular testing in the UK appeared to be in decline. The role of the caloric test as part of the traditional audiovestibular test battery employed to detect acoustic neuromas had been partly superseded by the more powerful and efficient combination of auditory brainstem testing and CT or MRI scans. The practical utility of ENG measurement of eye movements was questioned by many clinicians, who pointed out that a good history provided a sounder basis for diagnosis than the presence or absence of a few beats of nystagmus, or a borderline directional preponderance. At the same time, there were many indications in the research literature that improved means of testing the balance system were on the horizon: computerized tests that gave precise control of the visual or rotatory stimulus and hence permitted more fine-grained analysis of the nature of the vestibulo-ocular response; methods of assessing hitherto neglected aspects of the balance system, including postural control and otolith function; procedures (e.g. measures of tympanic membrane displacement and travelling wave velocity) which offered the possibility of providing diagnostic information about underlying pathology, to complement the information about site of lesion provided by the traditional tests.
机译：大约6年前，我负责在区域听力学中心提供和开发针对平衡障碍患者的测试。当时，英国的前庭检查似乎正在下降。热量测试作为用于检测听觉神经瘤的传统听神经束测试电池的一部分，已被听觉脑干测试和CT或MRI扫描的更强大和更有效的结合所部分取代。 ENG测量眼球运动的实用性受到许多临床医生的质疑，他们指出，良好的病史比存在或不存在少量眼球震颤或边缘性定向优势更能为诊断提供坚实的基础。同时，研究文献中有许多迹象表明，改进了对平衡系统进行测试的手段已迫在眉睫：计算机化测试可以精确控制视觉或旋转刺激，因此可以对颗粒性质进行更细致的分析。前庭眼反应；评估平衡系统迄今为止被忽略的方面的方法，包括姿势控制和耳石功能；程序（例如鼓膜位移和行波速度的测量）提供了提供有关潜在病理学诊断信息的可能性，以补充传统测试提供的有关病变部位的信息。

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