MedicalConsultation plan
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Patient is referred from ENT for a Audiovestibular assessment.

               
Take detailed history from patient.
Perform Tympanometry
YES
Perform Pure Tone Audiometry
YES
Perform bedside tests to check for conjugate eye movements and also perform head thrust and SKEW test.
YES
Perform CTSIB

YES

YES







YES
Perform Otoscopy
Perform Calorics
YES
Perform either VNG/ENG and conduct Smooth pursuit, Saccades, Gaze, and positionals
YES
Perfom Dynamic Visual acuity
YES
Perform Dix Halpike if history indicates BPPV



NO


YES




 
Perfrom VEMPS, rotating chair and head shake
YES
Debrief patient about results
YES
Decide whether Customised vestibular exercies are appropriate
YES
Book follow up appointment if they are to see them in a few weeks







NO

NO

 
 
 
Refer patient back to ENT