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Author Response

First, it is acknowledged that, because of the differential blood supply and innervation patterns of the peripheral vestibular apparatus, disorders in this area are likely to have combined involvement of both semicircular canal and otolith structures. However, this view may be somewhat simplistic, as it remains unknown whether the otolith organs and the semicircular canals are equally sensitive to vascular or neurally based inflammatory disorders.

Second, it is also acknowledged that the sensitivity with which caloric, vestibular evoked myogenic potential (VEMP), and static bias testing were able to identify vestibular dysfunction in the study participants was paramount in the group allocation process. The otolith function tests, in particular, have been reported to have a sensitivity in the range of 40% to 60%, and, for this reason, otolith dysfunction may not have been correctly identified across the study sample. It is important to recognize, however, that until recently otolith function could be measured only in research laboratories with elaborate and expensive equipment designed to measure horizontal, vertical, and torsional eye movements. The recent development of simple clinical tests, such as VEMP and static bias testing, has been an important step in the assessment of vestibular function. This study was the first of its kind to use these tools to advance our knowledge regarding the clinical presentation of individuals with peripheral vestibular dysfunction. As other, more sensitive, tests of otolith function are developed, this research can be progressed.

Kate J Murray, Keith D Hill, Bev Phillips and John Waterston

KJ Murray, PhD, is Physiotherapist, Dizzy Day Clinics, Melbourne, Victoria, Australia

	Footnotes

 
This letter was posted as a Rapid Response on February 22, 2007, at www.ptjournal.org.

This Article Full Text (PDF) Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Murray, K. J Articles by Waterston, J. Search for Related Content PubMed Articles by Murray, K. J Articles by Waterston, J.