Objective: To answer the question whether balance related systems have been affected in adults who recovered from Covid-19 disease. This is the first case-control study to assess balance objectively and quantitatively in Covid-19 disease. Methods: Thirty-seven patients who recovered from Covid-19 disease and 30 healthy controls were compared using Dizziness Handicap Inventory (DHI), Computerized Dynamic Posturography (CDP), Vestibular Evoked Myogenic Potentials(VEMP) and Video Head Impulse Test (v-HIT). Results: On CDP, the composite and visual general scores of the patients were significantly lower than controls (p<0.01). The v-HIT gains of the patients significantly decreased in the vertical semicircular canals compared to controls (p<0.01).There was a significant difference between the patients and controls regarding the absence of o-VEMPs (p<0.01) while the amplitudes and latencies were similar between the groups (p>0.05). Decreased P1/N1 amplitudes and elongated N1 latencies were found on c-VEMP testing (p<0.05). Anosmia, taste disorder and gender were not associated with subjective and objective test results (p>0.05). Conclusion: The Covid-19 disease can cause dizziness rather that incapacitating vertigo. Dizziness can be seen in almost one-fifth of the adult covid19 out-patients, which may be due to involvement of vestibular and visual systems,ortheir central connections. The squeals created in the balance related systems may be irreversible as they have persisted after the recovery of the patients. It is also plausible to anticipate more severe condition in the older patients who were treated in the intensive care units. In the long term follow up of the survivors, the need for balance rehabilitation programs should be remembered in order to minimize risks of falling down.

OBJECTIVE:The objective of this study was to establish which factor leads to a higher vestibulo-ocular reflex (VOR) gain: the timing of the movement or the direction of the movement. For this purpose, healthy volunteers were examined under three conditions: (1) when they were informed about the timing of the head movement; (2) when they were informed about the direction of the head movement; and (3) when they knew both the timing and the direction of the head movement. MATERIALS and METHODS:This study included data from 19 participants between the ages of 20 and 23 years with no neurological or vestibular ailments. The gains of the video head impulse test (vHIT) were measured under four different conditions and the final control tests. Five subgroups were defined, and the differences in the subgroups were assessed with using several statistical procedures. RESULTS:We found that there were significant differences between all subgroups gains on the right and left head rotations. Nevertheless, nonsignificant differences were found by performing independent samples t-tests and Mann-Whitney U tests between left and right head rotations for the pairwise comparisons of subgroups. Also, analysis of variance (ANOVA) results indicated that vHIT gains for the right and left , respectively). Thus, knowing the timing or direction or both does not affect vHIT gains. CONCLUSION:The results of these experiments revealed that there is no association whatsoever between VOR gain and awareness of the timing or direction of the movement or both.

Background We aimed to evaluate the significance of continuing audiovestibular practice during the Covid-19 pandemic in the audiology clinic of the university hospital. Methods The precautions, test procedures, and risk factors associated with the practice of audiology were evaluated. The number and diagnoses of the cases between 23 March and 23 May 2020 were also compared with the results of the same 2 months in 2019 in an attempt to evaluate the alterations in the audiology practice. Results The audiology practice has continued during the pandemic, and numerous audiovestibular tests like newborn hearing screening, pure tone and speech audiometry, auditory brainstem response (ABR) test, bedside vestibular assessment, videomystagmography (VNG), caloric test, vestibular evoked myogenic potential (VEMP), computerized dynamic posturography (CDP), video head impulse test (vHIT), intraoperative cochlear implant measurement, and postop cochlear implant fittings were performed. The number of tests has decreased significantly in the course of the pandemic (p < 0.01). No evidence of Covid-19 disease was detected in the audiology staff and patients. In general, no major risk was seen during testing under protective measures except for vestibular testing which induced vomiting and taking out the mask for lip reading during cochlear implant fitting in the elderly. Conclusion It is possible to perform audiovestibular tests during the Covid-19 pandemic by wearing necessary protective equipment and disinfecting the potential surfaces. Vomiting during vestibular tests, uncovering the nose and mouth for lip reading, and small-sized test cabins are the main risk factors of contamination in the audiology clinics.

Objective: The aim of this study was to investigate the normal gain values specific to each semicircular canals by using the goggle-less model of video head impulse test (vHIT) between ages of 20–39 and 40–60, gender and age-related gain values changes. Materials and Methods: The present study was performed in 99 participants aged 20–39 years and 100 participants aged 40–60 years. Each semicircular canal gain values were interpreted by comparing for both the age group of 20–39 and 40–60 years and gender. Results: The mean right lateral, right posterior, left lateral, and left posterior canal gain of 20–39 age group was significantly higher than the 40–60 age group. Regardless of age, while the mean left lateral canal gain in females was significantly higher than males, the mean right anterior and right posterior canal gain was significantly higher in males. The mean right lateral and the left lateral canal gains were significantly higher in females in the 20–39 years' age group; however, the mean right anterior, right posterior, and left posterior canals gains were significantly higher in males than in females. The mean right lateral canal gain in males was significantly higher in the 40–60 age group than that of females. Conclusions: The vHIT as a standard test for vestibular assessment provides clinical benefits, in addition the comparing for different age groups for goggle-less vHIT model will provide more beneficial results in the evaluation of patients. In the literature, there are not many studies on the goggle-less vHIT device, so we believe our study will be a pioneer in this field.

<b><i>Introduction:</i></b> Multiple sclerosis (MS) is an autoimmune disease that can affect balance, gait, and improve fall risk. The aim of this study was to investigate peripheral vestibular system involvement in MS and associations with the disease severity. <b><i>Methods:</i></b> Thirty-five adult patients with MS and 14 age- and gender-matched healthy controls were evaluated using video head impulse test (v-HIT), cervical vestibular evoked myogenic potential (c-VEMP), ocular vestibular evoked myogenic potentials (o-VEMPs), and sensory organization test (SOT) of computerized dynamic posturography (CDP). The results of both groups were compared, and association with EDSS scores was evaluated. <b><i>Results:</i></b> There was no significant difference between the groups regarding v-HIT and c-VEMP results (<i>p</i> &#x3e; 0.05). There was no association of the v-HIT, c-VEMP, and o-VEMP results with EDSS scores (<i>p</i> &#x3e; 0.05). There was no significant difference between the o-VEMP results of the groups (<i>p</i> &#x3e; 0.05) except for N1-P1 amplitudes (<i>p</i> = 0.01). The amplitudes of N1-P1 were significantly lower in the patients compared to controls (<i>p</i> = 0.01). There was no significant difference between the SOT results of the groups (<i>p</i> &#x3e; 0.05). However, significant differences were found within and between groups when the patients were categorized according to their EDSS scores with a cutoff point of 3 (<i>p</i> &#x3c; 0.05). There were negative correlations between the EDSS scores and composite (<i>r</i> = −396, <i>p</i> = 0.02) and somatosensory (SOM) scores (<i>r</i> = −487, <i>p</i> = 0.04) of CDP in the MS group. <b><i>Conclusion:</i></b> Although central and peripheral balance-related systems are affected in MS, the impact of disease on the peripheral vestibular end organ is subtle. In particular, the v-HIT, which was mentioned previously as a detector of brainstem dysfunction could not be a reliable tool in the detection of brainstem pathologies in MS patients. The o-VEMP amplitudes may be affected in the early stages of the disease, possibly due to the crossed ventral tegmental tract, oculomotor nuclei, or interstitial nucleus of Cajal involvements. An EDSS score &#x3e;3 seems a cutoff level indicating abnormalities in balance integration.