Position Statement: Rotational (Rotary) Chair Testing

The American Academy of Otolaryngology—Head and Neck Surgery recognizes that the following tests are medically indicated and appropriate in the evaluation of certain persons with suspected balance or dizziness disorders:

1. Rotational chair step velocity testing
2. Rotational chair sinusoidal harmonic acceleration testing
3. Rotational chair high frequency or high velocity sinusoidal rotation
4. Rotational chair rotation with visual fixation

Adopted 9/20/2014

References:

1. Baloh RW, Horubia V. Rotational and Other Newer Diagnostic Tests. In: Clinical Neurophysiology of the Vestibular System (Edition 2). F. A. Davis Company, Philadelphia, 1990:153-173.
2. Baloh RW, Yee RD, Jenkins HA, Honrubia V. Quantitative Assessment of Visual-Vestibular Interaction Using Sinusoidal Rotary Stimuli. In: Hobrubia V, and Brazier AB (Eds.): Nystagmus and Vertigo. Academic Press, New York, 1982.
3. Bojrab DI, Stockwell CW. Results of Rotational Testing in Dizzy Patients. In: Dizziness and Balance Disorders. An Interdisciplinary Approach to Diagnostic Treatment and Rehabilitation. Arenberg IK (Ed.). Kugler Publications, New York, 1993:331-337.
4. Hess K, Baloh RW, Honrubia V. Rotational Testing in Patients with Bilateral Peripheral Vestibular Disease. Laryngoscope; 95:85-88,1985.
5. Rubin W. The SHA test in Vestibular Diagnosis. Laryngoscope; 81:1702-1704,1981.
6. Valente LM. Assessment techniques for vestibular evaluation in pediatric patients. Otolaryngol Clin North Am. Apr 2011;44(2):273-90.
7. Arriaga MA, Chen DA, Cenci KA. Rotational chair (ROTO) instead of electronystagmography (ENG) as the primary vestibular test. Otolaryngol Head Neck Surg. Sep 2005;133(3):329-33.
8. Sugita-Kitajima A, Koizuka I. Evaluation of the vestibule-ocular reflex using sinusoidal off-vertical axis rotation in patients with canal paresis. Auris Nasus Larynx Feb 2014;41(1):22-26.
9. Won-Ho Chung and Hosuk Chu. Clinical Role of Rotary Chair Test, ENG and CDP. Otolaryngology — HNS 2010 143: P226.
10. Hoffer ME, Gottshall K, Kopke RD, Weisskopf P, Moore R, Allen KA and Wester D (2003). “Vestibular testing abnormalities in individuals with motion sickness.” Otol Neurotol 24(4): 633-6.

Important Disclaimer Notice (Updated 7/31/14)
Position statements are approved by the American Academy of Otolaryngology—Head and Neck Surgery or Foundation (AAO-HNS/F) Boards of Directors and are typically generated from AAO-HNS/F committees. Once approved by the Academy or Foundation Board of Directors, they become official position statements and are added to the existing position statement library. In no sense do they represent a standard of care. The applicability of position statements, as guidance for a procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. Adherence to these clinical position statements will not ensure successful treatment in every situation. As with all AAO-HNS/F guidance, this position statement should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results. Position statements are not intended to and should not be treated as legal, medical, or business advice.