The association between video-nystagmography and sensory organization test of computerized dynamic posturography in patients with vestibular symptoms

  • Shany G. GofritEmail author
  • Ophir Ilan
  • Yulia Mayler
  • Ron Eliashar
  • Tali Bdolah-Abram
  • Marrigje Aagje de Jong
  • Menachem GrossEmail author



Vertigo is a complex symptom which imposes diagnostic and treatment challenges. Laboratory evaluation of vertigo includes video-nystagmography (VNG) and computerized dynamic posturography (CDP) for the evaluation of different aspects of this complaint. There are vague indications for each test and potential disagreements between them. The aim of this study is to examine the association between the test results of the VNG and sensory organization test (SOT) of CDP in patients referred for both vestibular tests.


Retrospective data regarding 56 patients age 17–82 years were collected. Patients suffered vestibular complaints and were referred for VNG and CDP evaluation on the same day. The level of agreement between VNG (including caloric test) and the vestibular input of the SOT for each patient was calculated.


Among the study group, 10 showed abnormal caloric test results, of which 3 (5.4%) had normal vestibular input in the SOT, and 7 (12.5%) had impaired input (p = 0.724). Spontaneous nystagmus was recorded in 13 patients by VNG, of which 2(3.6%) had normal vestibular input and 11(19.6%) had impaired vestibular input (p = 0.056).


This study shows no statistically significant association between the VNG test and SOT test results. Our results emphasize the difference between the tested aspects in each laboratory test, and the need to define specific indications for each of them. There is a marginally significant association between impaired vestibular input and spontaneous nystagmus, demonstrating the non-localizing nature of this sign.


Video-nystagmography Computerized dynamic posturography Sensory organization test Dizziness Vertigo 



The authors thank Sara Malachi and Vladimir Rodionov from the ENG/VNG laboratory of the Department of Otolaryngology – Head & Neck Surgery, Hadassah Hebrew-University Medical Center, Jerusalem, Israel, for their great contribution throughout this study.


No funding was used in this research.

Compliance with ethical standards

Conflict of interest

This study was not sponsored by any organization. The authors have no conflict of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The data were gathered retrospectively, and without mentioning any details regarding the subjects.


  1. 1.
    Gofrit SG, Mayler Y, Eliashar R, Bdolah-Abram T, Ilan O, Gross M (2017) The association between vestibular physical examination, vertigo questionnaires, and the electronystagmography in patients with vestibular symptoms. Ann Otol Rhinol Laryngol 126(4):315–321CrossRefGoogle Scholar
  2. 2.
    Keim RJ (1985) The pitfalls of limiting ENG testing to patients with vertigo. Laryngoscope 95(10):1208–1212CrossRefGoogle Scholar
  3. 3.
    Gordon CR, Shupak A, Spitzer O, Doweck I, Melamed Y (1996) Nonspecific vertigo with normal otoneurological examination. The role of vestibular laboratory tests. J Laryngol Otol 110(12):1133–1137CrossRefGoogle Scholar
  4. 4.
    Goebel JA, Sataloff RT, Hanson JM, Nashner LM, Hirshout DS, Sokolow CC (1997) Posturographic evidence of nonorganic sway patterns in normal subjects, patients, and suspected malingerers. Otolaryngol Head Neck Surg 117(4):293–302CrossRefGoogle Scholar
  5. 5.
    Nashner L (2014) Computerized dynamic posturography. In: Jacobson GP, Shepard NT (eds) Balance function assessment and management. Plural Publishing Inc, San Diego, pp 451–479Google Scholar
  6. 6.
    Liu J, Zhou R, Liu B, Leng Y, Liu J, Liu D et al (2017) Sensory organization test principally reflects utricular function. Acta Otolaryngol 137(11):1143–1148CrossRefGoogle Scholar
  7. 7.
    Jacobson CP, Newman CW, Kartush J (1993) Handbook of balance function testing. Mosby, St. LouisGoogle Scholar
  8. 8.
    Coats AC (1966) XCVII Directional Preponderance and Spontaneous Nystagmus. Ann Otol Rhinol Laryngol 75(4):1135–1159CrossRefGoogle Scholar
  9. 9.
    Sataloff R, Hawkshaw M, Mandel H (2005) Abnormal computerized dynamic posturography findings in dizzy patients with normal ENG results. Ear Nose throat 212(4):84Google Scholar
  10. 10.
    Lipp M, Longridge N (1994) Computerised dynamic posturography: its place in the evaluation of patients with dizziness and imbalance. J Otolaryngol 23(3):177–183Google Scholar
  11. 11.
    Dobie R (1997) Does computerized dynamic posturography help us care for our patients? Otol Neurotol 18(1):108–112Google Scholar
  12. 12.
    Fetter M, Diener HC, Dichgans J (1991) Recovery of postural control after an acute unilateral vestibular lesion in humans. J Vestib Res 1(4):373–383Google Scholar
  13. 13.
    Keim RJ (1993) Clinical comparisons of posturography and electronystagmography. Laryngoscope 103(7):713–716CrossRefGoogle Scholar
  14. 14.
    McCollum G, Shupert CL, Nashner LM (1996) Organizing sensory information for postural control in altered sensory environments. J Theor Biol 180(3):257–270CrossRefGoogle Scholar
  15. 15.
    Peterka RJ, Black FO (1990) Age-related changes in human posture control: sensory organization tests. J Vestib Res-Equilib Orientat 1(1):73–85Google Scholar
  16. 16.
    Shepard NT (1989) The clinical use of dynamic posturography in the elderly. Ear Nose Throat J 68(12):940–957Google Scholar
  17. 17.
    Wall C 3rd, Black FO (1983) Postural stability and rotational tests: their effectiveness for screening dizzy patients. Acta Otolaryngol 95(3–4):235–246CrossRefGoogle Scholar
  18. 18.
    Blaszczyk JW, Bacik B, Juras G (2003) Clinical assessment of postural stability. J Mech Med Biol 3(2):135–144CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Shany G. Gofrit
    • 1
    • 2
    Email author
  • Ophir Ilan
    • 1
    • 2
  • Yulia Mayler
    • 2
  • Ron Eliashar
    • 1
    • 2
  • Tali Bdolah-Abram
    • 1
  • Marrigje Aagje de Jong
    • 2
  • Menachem Gross
    • 1
    • 2
    Email author
  1. 1.Hadassah Hebrew-University School of MedicineJerusalemIsrael
  2. 2.Department of Otolaryngology, Head and Neck SurgeryHadassah Hebrew-University Medical Center, HospitalJerusalemIsrael

Personalised recommendations