What is included in pre-procedure planning for electronystagmography (ENG)?

Updated: Aug 06, 2019
  • Author: Angela G Shoup, PhD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Outer and middle ear status should be confirmed prior to caloric assessment. Presence of drainage in the outer ear canal may affect the results obtained with air caloric stimulation because moisture changes the calibrated temperature, thus limiting interpretation. Pressure equalization tubes or perforation of the tympanic membrane precludes the use of water irrigation.

Large unilateral perforations limit the interpretation of air caloric irrigations. Large perforations can increase stimulation with cool air above calibrated expectation and can exhibit a cooling effect for warm air as moisture of the middle ear mucosa is evaporated. Excessive cerumen must be removed prior to any caloric stimulation. Middle ear fluid limits the effective stimulation of the vestibular system with air and water.

Many medications can affect test results. With physician approval, patients should discontinue all medications, unless contraindicated, for 24-72 hours prior to testing. Any medications taken should be clearly noted on the test results. Alcohol consumption can affect ENG test results for 72 hours after ingestion; results are unpredictable because alcohol can be an agonist or antagonist.

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