(2012) described the association between hearing loss and dysfunction of each of the five vestibular end-organs-the horizontal, superior, and posterior semicircular canals the saccule and the utricle-in older individuals ( n=51, aged ≥70 years). (2009) found that participants with vestibular dysfunction had significantly increased odds of hearing loss compared with participants without vestibular dysfunction in multivariate analyses (OR=1.9 95% CI=1.1–3.1). (2009) studied vestibular function in the 2001–04 National Health and Nutrition Examination cross-sectional surveys of US adults aged 40 years and older ( n=5086), and included associations between vestibular dysfunction and hearing loss. Using the modified Romberg Test of Standing Balance on Firm and Compliant Support Surfaces, Agrawal et al. Eggermont, in The Auditory Brain and Age-Related Hearing Impairment, 2019 10.1.5 ARHI and Vestibular Problems The clinical triad of a pathologic Romberg test on foam, decreased dynamic visual acuity, and catch-up saccades after head impulses to both sides is pathognomonic for a bilateral vestibular loss ( Petersen et al., 2013). Notice that, in the absence of a vestibular deficit, the Romberg test on foam is also positive in patients with midline cerebellar disorders. As a result, the test is very sensitive to identify patients with unilateral or bilateral vestibular loss. Even healthy subjects show increased sway on foam (without falling). The Romberg test on rubber foam, on the other hand, mainly probes the vestibulospinal reflexes, as the foam minimizes the proprioceptive input from the feet ( Shumway-Cook and Horak, 1986). The Romberg test is also not very sensitive: patients stand relatively stable even with substantial vestibular or proprioceptive deficits. A positive Romberg test is nonspecific: vestibular, proprioceptive, or cerebellar deficits as well as combinations thereof may lead to increased sway. The test is positive if a patient sways more than normal or falls without being held up by the examiner. In this situation with the visual input cancelled, postural control relies on vestibular input and proprioceptive input alone. Straumann, in Handbook of Clinical Neurology, 2016 Romberg test on rubber foam padįor the original Romberg test, the patient stands with feet together, hands by the sides, and eyes closed.
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