Vestibular Assessment: new tools and developments to assess patients with balance problems

Description, Outcome Objectives, and Background: Caloric testing has long been a cornerstone of vestibular evaluation, offering low-frequency stimulus insights into unilateral vestibular function. However, with the evolution of high-frequency tests and increasing preference for quicker, more tolerable methods, the relevance of calorics is under scrutiny.

This keynote will:

• Reframe the current clinical role of caloric testing in differential diagnosis

• Compare water versus air caloric stimulation in terms of reliability, tolerability, and accuracy

• Highlight scenarios where caloric testing provides diagnostic clarity that other tests may not

• Address common technical pitfalls and interpretation challenges

• Clarify how caloric data should be integrated with other vestibular test findings to inform rehabilitation and management

Key distinctions between air and water irrigations will be emphasized—discussing not only temperature transfer and patient comfort, but also implications for test reliability and artifact susceptibility.

Expected Outcomes: Participants will leave with:

• A refined understanding of how and when to use caloric testing appropriately

• Practical insight into optimizing air and water protocols

• Clear decision-making strategies for integrating caloric results with modern test batteries

• A deeper appreciation for the test's continued relevance in selected clinical context