Author Topic: ENG caloric test results  (Read 10980 times)


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ENG caloric test results
« on: March 23, 2009, 11:19:13 pm »
When I had the ENG test done, I still at that point had no idea that I had an AN.  I just thought it was a test to see/clarify why my hearing in my left ear was diminished.  As such, I didn't ask too many questions about the results (even though it was clear to me that there was a problem).

Now, it's bothering me and I'm trying to figure out what it means.  I had the caloric basic tests done and my left ear was unresponsive.  They did the ice cold test and it didn't respond at all (she explained to me that sometimes they use that to "jump start" a response).  When it did nothing at all/didn't affect me, I knew something was wrong.

After researching online, the best I can come up with is that if there is an abnormal response after the ice water test, there is likely permanent damage to the nerve of the inner ear that controls balance.  So what exactly does that mean for me?  Does that mean that my balance will get worse?  Does that mean that I'm already so imbalanced and have compensated for it, that I likely won't notice further balance issues?  What does that mean for my surgery (if I choose to go that route).  Does it make it more likely that I will/will not have a bad outcome from surgery?   I just don't get it.

Anything you can tell me is appreciated, whether from first hand experience or from an online resource.

Thank you(again!)

3.0 x 3.0 x 2.5 cm AN, left side.  Diagnosed Feb. 19th,2009
Retro Sig surgery with Dr. Akagami and Dr. Westerberg on May 26/09 at Vancouver General Hospital
SUCCESS! Completely removed tumor, preserved facial nerve, and retained a lot of hearing. Colour me HAPPY!


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Re: ENG caloric test results
« Reply #1 on: March 23, 2009, 11:29:44 pm »
Does that mean that I'm already so imbalanced and have compensated for it, that I likely won't notice further balance issues?

That is my impression from various accounts here. If you are getting no response, your AN side balance nerve has already effectively shut down, and you are operating on just one now. Surgery will be the coup de grâce, but you should not have any severe balance issue - just the usual wobble and gradual adjustment.

Unless it turns out otherwise. :)

8 mm left AN June 2007,  CK at Stanford Sept 2007.
Hearing lasted a while, but left side is deaf now.
Right side is weak too. Life is quiet.


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Re: ENG caloric test results
« Reply #2 on: March 24, 2009, 08:05:53 am »
  Does that mean that I'm already so imbalanced and have compensated for it, that I likely won't notice further balance issues?


For what it's worth, I can describe my experience. I had a small-ish AN (approx. 1.3 cm.). My only pre-diagnosis symptom was gradual hearing loss (with very mild tinnitus) and I'm assuming that my AN grew slowly and steadily over a number of years, effectively zapping my balance nerve along with my hearing. To this day, neither I nor my family can recall any time in the past when I experienced any dizziness or balance issues at all. I experienced absolutely no balance or dizziness issues following my translab surgery in January 2008. I met with a physical therapist two days after surgery (I had already been up and about, walking to the bathroom, etc.) and he spent about 15 minutes with me, walking the halls, doing some balance exercises, etc. He said, "you don't need me," and told me just to continue walking as much as I could. In the first few months after surgery I experienced occasional "wonky-headness" -- e.g., in Home Depot-type places and when I would stand up quickly after sitting or riding in a car -- but it was always just momentary and never a problem.

I hope you'll have a similar outcome and that dizziness, etc. won't be a challenge you'll have to face.

Catherine (JerseyGirl 2)
Translab surgery and BAHA implant: House Ear Institute, Los Angeles, 1/2008
Drs. J. House, Schwartz, Wilkinson, and Stefan
BAHA Intenso, 6/2008
no facial, balance, or vision problems either before or after surgery ... just hearing loss
Monmouth County, NJ


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Re: ENG caloric test results
« Reply #3 on: March 24, 2009, 08:16:06 am »
Sounds like you had the same results as I did.  My AN ear didn't respond at all - but when they did my good ear - I felt like I'd just gotten off a carnival ride!   :o

The good news is, and this doesn't sound like good news, I know, but my balance nerve was only functioning at about 40% at that point, so over the years, my good side had been slowly compensating for the loss on the bad side.  This meant that after my translab, I hardly had any balance problems - I was a little wobbly for about 2 weeks, not to the point where I needed a cane or any real assistance, I was just more cautious and aware of my movements.  The first time out of bed in the ICU was a little challenging, but it got better quickly,and by day 2 post op, I was walking the halls at the hospital by myself, just holding onto the IV pole for a little support.  So, if your balance nerve is already not doing its job, you will most likely have the same outcome regarding balance as I did.

I think the lack of dizziness helped me to avoid the nausea and probably headaches too, because I haven't had a problem with either of those either.

So, it sounds like it would be a bad thing, but it will work in your favor in the long run. Sometimes our bodies do cooperate with us!   :D

Right 3cm AN diagnosed 1/2007.  Translab resection 2/20/07 by Dr. David Kaylie and Dr. Karl Hampf at Baptist Hospital in Nashville.  R side deafness, facial nerve paralysis.  Tarsorraphy and tear duct cauterization 5/2007.  BAHA implant 11/8/07. 7-12 nerve jump 9/26/08.


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Re: ENG caloric test results
« Reply #4 on: March 24, 2009, 08:59:21 am »
They did the water in the ear tests on me before surgery.  Warm and cool water.  I was sent spinning out of control, even in my AN ear, which meant that my balance nerve was still largely intact.  In fact, that is my biggest post-op issue right now, balance.  I'd say it will help you tremendously if indeed your balance nerve is already compromised.  My surgeon said he was surprised that my balance nerve was still performing so well given that it was completely enveloped by the tumor.  Maybe if I had waited another year, I could have gradually adjusted to a decaying nerve :).
-1.3 X 0.8 cm AN in the right cerebellopontine angle extending into the internal auditory canal.
-Retrosigmoid Surgery with Dr. Bartels and Dr. Danner at Tampa General 3/5/2009.
-Had to cut hearing nerve to get "sticky" tumor, so SSD right side.

Jim Scott

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Re: ENG caloric test results
« Reply #5 on: March 24, 2009, 01:47:49 pm »
Adrienne ~

Although I never had the caloric reflex test, I think I can confidently echo the apparent consensus that the balance nerve on your 'AN side' is non-functional and your brain has compensated for the deficit and adjusted, accordingly.  I had a similar experience.  I was in ICU for 4 days and when I got up to walk (Day 3) I was shaky on my feet but soon regained my equilibrium.  Enough so that the stern and skeptical PT nurse (I think her name tag said 'Nurse Ratched') made me walk up and down stairs and navigate various obstacles in order to convince her that my balance was acceptable enough to warrant my discharge, even though my doctor had ordered my release.  It was.  Once home, I had a PT nurse from the VNA for 3 visits before she stated that I didn't really need her and to just do the printed exercises and walk a lot, which I eagerly did.  Thankfully, I didn't have post-op headaches, never really experienced the 'wonky head' syndrome or had any problem in large, noisy environments.  However, my balance is probably about 20% less effective than it was prior to my AN.  I can live with that as it doesn't really affect my lifestyle in any noticeable way.     

While no one can accurately predict the precise outcome of your surgery (should you go that route) the fact that your brain has already compensated for the loss of input from the affected ear, due to nerve damage, should be a benefit for your recovery, as regaining the ability to balance and navigate most places won't be a major issue. 

4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.