Rotary chair offers more concise diagnosis for TBI patients

Posted by Kerrie Denner

Loosely coined the “spin chair,” a new piece of equipment at Naval Hospital Camp Lejeune is now being used by service members who have suffered traumatic brain injury to aid doctors with their diagnoses.

Housed at the ear, nose and throat clinic at the Naval Hospital, the lab offers patients state-of-the-art equipment that tests a variety of vestibular complications that can come as a result of a TBI, whether it be mild, moderate or severe. Whether it is from a blast injury or a recent fall, the Neuro-Otologic Test Center can assist patients who may be experiencing vertigo, which includes dizziness and light-headedness.

“The NOTC system provides data that aids in the diagnosis and helps localize the problem whether it is central or peripheral,” said Maria Holdren, a staff audiologist and vestibular specialist at the hospital. “The doctors and audiologists resulting diagnosis will help guide the treatment and therapy (of the patient.)”

The vestibular system of the body, according to the Vestibular Disorders Association, is responsible for balance and eye movements and affects a person’s ability to function and perform day-to-day activities. The system includes the inner ear and brain, and if diseased or damaged can result in balance and eye movement problems for patients.

Vestibular audiology, a highly specialized area, according to Holdren, allows providers to use equipment in order to better provide services to patients. The chair, she said, does not result in any sickness but can cause minimal discomfort in the form of vertigo. The chair simulates real life motion and frequencies, which results in usable data for doctors. 

Prior to the spin chair, caloric testing was used; but sometimes caused discomfort to patients when doctors would irrigate the ears with cool and warm air. Now, in the chair, patients are presented various stimuli in the form of dots, lines and rotating dot patterns to focus on since the eyes are “an important part” of the vestibular system, according to Holdren.

“Right now, the size and cost (of the NOTC system) are the biggest limitations,” Holdren said. “This is not a piece of equipment that any clinic would be able to acquire and use. We are extremely fortunate to have the rotary chair.”

Many patients, she said, have had a “wow” moment when they look at the machine and request photographs of them sitting in the chair because of how high-tech it is. Before testing, all questions a patient may have are answered and the information that will be gathered is explained, she said.

Prior to the acquisition of the chair, according to Lt. Cmdr. Brent Driskill, the department head of the Otolaryngology Department, patients were sent to Wilmington for testing; but because the Naval Hospital now has these capabilities, they are able to provide convenient and centered care for patients who need the technology.

The chair, he said, is the next wave of technology at the Naval Hospital because the goal has been to increase the capability of the ENT and Audiology department in order to care for the conditions that affect the active duty population the most. Prior to the war and the increase in blast exposures, Driskill said that the technology was not really needed; but because of the change, a more comprehensive level of care was required.

“The vestibular testing, in addition to clinical history, exam and imaging help us determine which is the problem and, therefore, what is the treatment,” Driskill said. “Balance issues are very debilitating and also very hard to diagnose and treat. I can’t see a patient’s dizziness, therefore the testing is critical to determine the etiology and treatment.”

Source: JDNews


Accessed 5/6/2014

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