The Ohio State University Wexner Medical Center's balance disorders program offers state-of-the-art tests and treatments for patients with vestibular dysfunction (ear-related dizziness). Testing includes videonystagmography (VNG), vestibular myogenic evoked potentials (VEMP), fistula testing and, when necessary, a diagnostic hearing evaluation performed by an audiologist. Many of the conditions of ear-related dizziness are monitored by a neurotologist while being treated by our physician assistant.      

Our mission is to promote a better understanding of dizziness and related conditions through an integrated partnership between clinicians, researchers and medical staff.




Vestibular testing is a series of different tests that help determine issues with the part of the inner ear responsible for balance. These tests can help identify the cause of symptoms, leading to more appropriate treatment. Some of these tests include: 

Videonystagmography (VNG/ENG) – Videonystagmography is a battery of tests that use recording and analysis of eye movements to help determine the cause of a patient’s dizziness or imbalance. The recordings provide useful information on the function of various parts of the balance system, including the balance organs and nerves within in the ears, the portions of the balance system within the central nervous system (CNS) and the parts of the CNS responsible for generation and control of eye movements. Recordings are usually accomplished through the use of goggles equipped with infrared cameras, although under certain circumstances, electrodes placed around the eyes are used.

Testing is performed with the patient in an exam chair in a darkened room. During the test, eye movements are recorded while the patient follows patterns on a light bar, moves into different positions and undergoes irrigations in each ear with warm and cool fluids. The test findings provide information on whether symptoms result from dysfunction within the ear, the CNS or both, thereby helping the referring provider determine the cause. The duration of the test is usually between 60 and 75 minutes.

Vestibular Evoked Myogenic Potential (VEMP) testing – VEMPs are muscle (myogenic) responses triggered by stimulation of the otolith organs. These organs are part of the inner ear balance system and are responsible for detecting both linear movements (forward/backward, side-to-side, up/down) and gravity and how the head is oriented with respect to it. To help determine the cause of a patient’s dizziness or imbalance, VEMP testing is used to assess the function of the otolith organs and their related signal pathways through the vestibular nerve and the central nervous system. VEMP testing is also used to determine whether an abnormal opening (dehiscence) or thinning of the bone that surrounds the inner ear is responsible for the patient’s symptoms. 

VEMP responses are measured through electrodes placed over the neck muscles and sometimes over the muscles beneath the eyes. During the test, the response is generated by presenting a repeated loud “popping” sound to an ear while the patient tenses the neck muscles by raising or turning the head, or by tensing the eye muscles by gazing upward. The duration of the test is usually between 30 and 60 minutes.



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Saul Strieb, AuD

Audiologist & Vestibular Laboratory Coordinator

Saul Strieb, AuD, obtained his bachelor’s degree from the University of Chicago and his master’s degree in Audiology from the University of Maryland. He received his doctoral degree in Audiology from the University of Florida in 2009. He served as an audiologist at the Washington Hospital Center from 2001 through 2011, before joining the staff of the OSU Department of Otolaryngology -- Head and Neck Surgery in 2011. His clinical interests include hearing aids, BAHA, vestibular assessment and treatment of benign paroxysmal positional vertigo.

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