What balance disorder research is conducted at the Eye and Ear?

A project to assess the use of an Omniax positioning system in a multi-disciplinary balance service which specialises in both vestibular (inner ear balance mechanism) and central (brain balance centre) impairment. Find out more.

A project to understand how common depression and anxiety is for Australian patients with dizziness will be completed shortly. This is the first project of this kind in Australia looking at a specialist balance clinic population.

A questionnaire is being developed for patients to complete before to their consultation. This intends to help clinicians make an accurate and timely diagnosis of the cause of the patient’s dizziness.

In 2004, Eye and Ear specialist, Dr David Szmulewicz and his colleagues first described a balance disorder called cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS). Theylater established that it runs in some families. Affecting all three parts of the balance system, which include the cerebellum in the brain, the inner ear’s vestibular system, and sensors in the feet, the syndrome is a form of cerebellar ataxia. Dr Szmulewicz and his team are now collaborating with researchers internationally to search for the gene that causes this condition.

In conjunction with Associate Professor Pubudu Pathirana, Deakin University and Professor Malcolm Horne, The Florey Institute of Neurosciences and Mental Health, devices are being developed to help diagnose and guide the management of patients with cerebellar disorders.

You can listen to an interview with Dr David Szmulewicz on ABC radio discussing balance disorders.

A new method of testing a lesser known part of the inner ear balance mechanism called the otolith organs is being assessed In collaboration with Sydney University researchers Dr Hamish MacDougall, Dr Elodie Chiarovano and Mr Stephen Rogers.

The temporal bone is the part of the skull that houses the inner ear’s balance and hearing systems. During Dr Szmulewicz’s research into the balance condition CANVAS (explained above), microscopic examination of the temporal bone provided an insight into the disease process.

Together with Professor Stephen O’Leary, Department of Otolaryngology at the University of Melbourne, Dr Szmulewicz has established the Australian temporal bone bank (ATBB) at the Eye and Ear in order to enable research into other balance disorders. Temporal bone samples are harvested from deceased donors in a surgical procedure carried out immediately after death and stored for future research.

Our balance disorder and ataxia service team hopes that patients with hearing and balance disorders will register as a temporal bone bank donor and contribute to research into improved treatments for debilitating balance disorders. For more information visit the Temporal Bone website and download the Temporal Bone Bank brochure

Dr David Szmulewicz, Brooke Paisely (Manager of Audiology, Speech and Balance Services) and Arimbi Winoto (Senior Vestibular Physiotherapist) are currently developing an interactive computer application that provides prompts for the assessment of vertigo by emergency doctors and GPs.

The interactive vertigo assessment tool, known as iVAT, directs users through a series of questions and physical examinations necessary to fully assess the potential cause of vertigo. Once a provisional diagnosis has been made, the application then suggests investigations and treatments, as well as highlighting features that may indicate a more serious condition, or one requiring immediate specialist attention.

This tool is the first of its kind for balance disorders. The aim is to support and update frontline clinicians on the accurate diagnosis and management of balance disorders.