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VAT and VORTEQ (Tm) -- Vestibular Autorotation testing

Timothy C. Hain, MD Page last modified: April 5, 2014 button Return to testing index

There are several other alternative procedures to rotatory chair testing. Two tests use active head movement (autorotation)-- brand names for these devices are   "VAT", and the "VORTEQ". Both of these tests provide a part of the the rotatory chair test information (the high-frequencies), and measure something a little different --  the contribution of the inner ear, cognitive input, and neck inputs to nystagmus rather than the contribution of the inner ear alone (Dell Santina et al, 2002).

If you have a rotatory chair test, there is no need to get a "VAT" or "VORTEQ" test as the information supplied is largely redundant. It is possible to have a moderate loss of vestibular function on a rotatory chair test, but have the VAT/VORTEQ test miss the diagnosis entirely. This is particularly possible in a person who has had a few years to compensate for a bilateral vestibular loss. However, if a rotatory chair test is not available, these test may have some value.

VAT tests have been used in unilateral syndromes(Perez et al. 2003), but we think that caloric testing would be superior


(for more about vestibular testing fraud, see here)

These devices have been used by unscrupulous groups to "game" the Medicare billing system was to bill repeatedly (on the same day) for "sweeps" of active head movement testing. While there is some value to these tests, they are not as useful as a "real" rotatory chair and also do not require anywhere near the same investment of space and equipment as the "real system".