Overview
The full diagnostic testing that was completed in office assessed all 10 end organs of the inner ear (five in
the left ear and five in the right ear) and their corresponding branches of the VIIIth cranial nerve, which
contribute to three main reflexes in the balance system: the vestibular ocular reflex (VOR), the
vestibulospinal reflex (VSR), and the otolith ocular reflex (OOR). Testing indicated a specific vestibular
dysfunction (vestibulopathy) with significant VOR, VSR, OOR dysfunction or a combination thereof. A
customized treatment protocol will be developed and applied both in clinic and at home through a
proprietary system called Advanced Vestibular Treatment (AVT). The goal is to further promote
compensation of any identified vestibulopathy, and further improve a patient’s frequency, severity and
duration of symptoms.
Advanced Vestibular Treatment (AVT) is a specialized and proprietary audiologist-directed vestibular
rehabilitation program, developed by NMABEI, that strengthens the inner ear vestibular system to reduce
symptoms of vertigo, dizziness, and imbalance. AVT focuses on strengthening the vestibular reflexes
(VOR, VSR and OOR) through central compensation or synaptic reorganization, the process of brain
plasticity that allows for new neural connections to be made to help adjust for a person’s changing
balance or motion.
During the course of AVT, the patient’s progress is tracked through subjective patient reported
improvement of symptoms and objective measures related directly to the function of the inner ear. The
managing audiologist will use these measures to further modify and direct the course of treatment. In the
preferred clinical approach, the patient is seen twice weekly in the clinic. In between sessions, the patient
performs individualized, customized home-treatment sessions via internet access twice per day.
At the completion of treatment, the patient's objective data is compared to the normative data, and the
patient completes a subjective questionnaire with regards to their overall balance functionality. The
patient graduates from treatment after the three phases of treatment have been completed, and the
patient’s objective and subjective data fall within the normative data range or reveal significant
improvements. 93% of patients who complete six to eight weeks of AVT demonstrate measurable
objective and subjective improvement.