ASA S3 45-2009 American National Standard Procedures for Testing Basic Vestibular Function《测试基本前庭功能的规程》.pdf

1、ANSI/ASA S3.45-2009 (Revision of ANSI S3.45-1999)AMERICAN NATIONAL STANDARDProcedures for Testing Basic Vestibular Function Accredited Standards Committee S3, BioacousticsStandards Secretariat Acoustical Society of America 35 Pinelawn Road, Suite 114 E Melville, NY 11747-3177ANSI/ASA S3.45-2009 Reaf

2、firmed by ANSI May 12, 2014 The American National Standards Institute, Inc. (ANSI) is the national coordinator of voluntary standards development and the clearinghouse in the U.S.A. for information on national and international standards. The Acoustical Society of America (ASA) is an organization of

3、 scientists and engineers formed in 1929 to increase and diffuse the knowledge of acoustics and to promote its practical applications. ANSI/ASA S3.45-2009 (Revision of ANSI S3.45-1999) AMERICAN NATIONAL STANDARD Procedures for Testing Basic Vestibular Function Secretariat: Acoustical Society of Amer

4、ica Approved January 8, 2009: American National Standards Institute, Inc. Abstract This Standard defines procedures for performing and reporting a battery of tests for the evaluation of human vestibular function. Six different tests are specified. Stimuli are presented to evoke eye movement by a sub

5、ject whose response is determined either by measurement of electrical signals generated by the eye movements or by image processing methods applied to video eye movements. The Standard specifies test procedures, measurements, data analysis, and data reporting requirements. These tests, including the

6、 data analysis and reporting procedures, are called the Basic Vestibular Function Test Battery. Test interpretation is not a part of this Standard. AMERICAN NATIONAL STANDARDS ON ACOUSTICS The Acoustical Society of America (ASA) provides the Secretariat for Accredited Standards Committees S1 on Acou

7、stics, S2 on Mechanical Vibration and Shock, S3 on Bioacoustics, S3/SC 1 on Animal Bioacoustics, and S12 on Noise. These committees have wide representation from the technical community (manufacturers, consumers, trade associations, organizations with a general interest, and government representativ

8、es). The standards are published by the Acoustical Society of America as American National Standards after approval by their respective Standards Committees and the American National Standards Institute (ANSI). These standards are developed and published as a public service to provide standards usef

9、ul to the public, industry, and consumers, and to Federal, State, and local governments. Each of the Accredited Standards Committees (operating in accordance with procedures approved by ANSI) is responsible for developing, voting upon, and maintaining or revising its own Standards. The ASA Standards

10、 Secretariat administers Committee organization and activity and provides liaison between the Accredited Standards Committees and ANSI. After the Standards have been produced and adopted by the Accredited Standards Committees, and approved as American National Standards by ANSI, the ASA Standards Se

11、cretariat arranges for their publication and distribution. An American National Standard implies a consensus of those substantially concerned with its scope and provisions. Consensus is established when, in the judgment of the ANSI Board of Standards Review, substantial agreement has been reached by

12、 directly and materially affected interests. Substantial agreement means much more than a simple majority, but not necessarily unanimity. Consensus requires that all views and objections be considered and that a concerted effort be made towards their resolution. The use of an American National Stand

13、ard is completely voluntary. Their existence does not in any respect preclude anyone, whether he or she has approved the Standards or not, from manufacturing, marketing, purchasing, or using products, processes, or procedures not conforming to the Standards. NOTICE: This American National Standard m

14、ay be revised or withdrawn at any time. The procedures of the American National Standards Institute require that action be taken periodically to reaffirm, revise, or withdraw this Standard. Acoustical Society of America ASA Secretariat 35 Pinelawn Road, Suite 114E Melville, New York 11747-3177 Telep

15、hone: 1 (631) 390-0215 Fax: 1 (631) 390-0217 E-mail: asastdsaip.org 2009 by Acoustical Society of America. This standard may not be reproduced in whole or in part in any form for sale, promotion, or any commercial purpose, or any purpose not falling within the provisions of the U.S. Copyright Act of

16、 1976, without prior written permission of the publisher. For permission, address a request to the Standards Secretariat of the Acoustical Society of America. 2009 Acoustical Society of America iContents 1 Scope, purpose, and applications. 1 1.1 Scope. 1 1.2 Purpose 2 1.3 Applications 2 2 Normative

17、references 2 3 Terms and definitions 2 4 Instrumentation 4 4.1 Overview of instrumentation 4 4.2 Component and setup features common to and needed for both methods of eye movement measurement. 4 4.3 Components and setup features specific to electro-oculography 6 4.4 Videonystagmography and display 8

18、 5 Spontaneous and gaze-evoked nystagmus 9 5.1 Test purpose 9 5.2 Spontaneous test. 9 5.3 Gaze test 9 5.4 Data reporting 9 5.5 Measurement of slow component velocity. 10 6 Saccade test 11 6.1 Test purpose11 6.2 Visual target. 11 6.3 Procedure 11 6.4 Evaluation 11 7 Pursuit test 11 7.1 Test purpose11

19、 7.2 Visual target. 11 7.3 Procedure 12 7.4 Evaluation 12 8 Positioning and positional nystagmus. 12 8.1 Test purpose12 8.2 Dynamic (positioning) tests 12 8.3 Static (positional) tests. 13 8.4 Results to be reported . 14 9 Caloric test 14 9.1 Test purpose14 9.2 Test environment . 15 9.3 Data acquisi

20、tion . 15 2009 Acoustical Society of America ii 9.4 General test method 15 9.5 Fixation suppression 16 9.6 Test details 16 9.7 Role of the tester . 17 9.8 Analysis of test data. 17 9.9 Data to be reported 18 10 Report of test results . 20 10.1 Form of report 20 10.2 Standardized worksheet 20 Annex A

21、 (informative) Test interpretation 22 Annex B (informative) Air caloric stimulation. 24 Bibliography. 25 Tables Table 1 Positioning and positional maneuvers. 13 Table 2 Standard caloric stimulus values . 16 Figures Figure 1 Example of electro-oculogram (EOG) calibration. 6 Figure 2 Normal electrode

22、placement. 6 Figure 3 Estimate of slope of slow component of nystagmus 10 Figure 4 Start and end positions for example positioning (dynamic) and positional (static) maneuvers: A) Positioning, head straight while sitting, and head extended while supine; B) Positioning, head left; C) Positioning, supi

23、ne, head left 14 Figure 5 Example of calculation of slow component velocity of nystagmus. 18 Figure 6 Worksheet for the basic vestibular function test battery. 21 Figure A.1 Sample test report normal subject . 22 Figure A.2 Sample test report abnormal subject . 23 2009 Acoustical Society of America

24、All rights reserved iiiForeword This Foreword is for information only, and is not a part of the American National Standard ANSI/ASA S3.45-2009 American National Standard Procedures for Testing Basic Vestibular Function. This standard comprises a part of a group of definitions, standards, and specifi

25、cations for use in bioacoustics. It was developed and approved by Accredited Standards Committee S3, Bioacoustics, under its approved operating procedures. Those procedures have been accredited by the American National Standards Institute (ANSI). The Scope of Accredited Standards Committee S3 is as

26、follows: Standards, specifications, methods of measurement and test, and terminology in the fields of psychological and physiological acoustics, including aspects of general acoustics which pertain to biological safety, tolerance and comfort. This standard is a revision of ANSI S3.45-1999, which has

27、 been technically revised. An alternate means for the measurement of eye movements using video-oculography (VOG) has been added, since this method has advantages of being less invasive, and can be used to display and measure torsional eye movements that are not possible with electro-oculography. A 5

28、-year exception to the standard, which permitted use of older computerized equipment which sampled ENG signals at 50 samples per second, was eliminated since current technology is capable of supporting the 100-sample-per-second rate specified in the standard. The issues that needed to be addressed b

29、efore the use of air as a medium for caloric irrigations could be incorporated into the standard have been added in an informative annex. One normative reference was added in Clause 2, and additional informative resources were added to the bibliography, primarily regarding the use of video-oculograp

30、hy. This standard is not comparable to any existing ISO Standard. At the time this Standard was submitted to Accredited Standards Committee S3, Bioacoustics, for approval, the membership was as follows: C.A. Champlin, Chair R.F. Burkard, Vice-Chair S.B. Blaeser, Secretary Acoustical Society of Ameri

31、ca C.A. Champlin R.F. Burkard (Alt.) American Academy of Audiology .Y. Szymko-Bennett D.A. Fabry (Alt.) American Academy of Otolaryngology, Head and Neck Surgery, Inc. .R.A. Dobie .L.A. Michael (Alt.) 2009 Acoustical Society of America All rights reserved iv American Industrial Hygiene Association .

32、 T.K. Madison D. Driscoll (Alt.) American Speech-Hearing-Language Association (ASHA) .L.A. Wilber V. Gladstone (Alt.) Beltone/GN Resound S. Petrovic Council for Accreditation in Occupational Hearing Conservation (CAOHC)E.H. Berger .J. Banach (Alt.) Etymotic Research, Inc. . M.C. Killion .R. Scicluna

33、 (Alt.) Frye Electronics, Inc. .G.J. Frye K.E. Frye (Alt.) Hearing Industries Association T.A. Victorian .C.M. Rogin (Alt.) National Hearing Conservation Association . T. Schulz National Institute for Occupational Safety and Health M. Stephenson .W.J. Murphy (Alt.) National Institute of Standards an

34、d Technology .V. Nedzelnitsky R. Wagner (Alt.) Quest Technologies, Inc.M. Wurm .P. Battenberg (Alt.) Starkey Laboratories D.A. Preves . T. Burns (Alt.) U.S. Air Force R. McKinley U.S. Army Aeromedical Research Lab. W. Ahroon Vacant (Alt.) U.S. Army CERL.L. Pater . D. Delaney (Alt.) U.S. Army Researc

35、h Laboratory, Human Research and Engineering Directorate T.R. Letowski .P. Henry (Alt.) Individual Experts of the Accredited Standards Committee S3, Bioacoustics, were: J.R. Bareham T. Frank P.D. Schomer A.J. Brammer K.D. Kryter L.A. Wilber A.J. Campanella R. McKinley W.A. Yost 2009 Acoustical Socie

36、ty of America All rights reserved vWorking Group S3/WG 82, Basic Vestibular Function Test Battery, which assisted Accredited Standards Committee S3, Bioacoustics, in the development of this standard, had the following membership. C. Wall, III, Chair R. Burkard E.M. Monsell J.M. Furman N.T. Shepard R

37、. Miles Suggestions for improvements of this standard will be welcomed. They should be sent to Accredited Standards Committee S3, Bioacoustics, in care of the Standards Secretariat of the Acoustical Society of America, 35 Pinelawn Road, Suite 114E, Melville, New York 11747-3177. Telephone: 631-390-0

38、215; FAX: 631-390-0217; E-mail: asastdsaip.org. 2009 Acoustical Society of America All rights reserved vi Introduction The vestibular system provides information related to a persons orientation in space using information from five organs in each inner ear. Three of these organs sense angular accele

39、ration in approximately orthogonal planes, while two sense linear acceleration and gravity. This peripheral information is integrated with that of other senses, including vision and proprioception, to give information about the orientation of the individual in space and to allow for appropriate comp

40、ensatory reflexive movements. These reflexes can adapt in ways that enhance a persons ability to cope with changing conditions. Two major reflexes involved are the vestibulo-ocular reflex and the vestibulo-spinal reflex. The former allows one to keep visual objects of interest stable on the retina w

41、hile the person is in motion. The latter allows one to maintain postural stability when subjected to motion. These reflexive movements can be used to evaluate the response to vestibular stimuli. This Standard utilizes the vestibulo-ocular reflex as its basis for test procedures. A variety of test me

42、thods has been used in clinical and research evaluations of vestibular function. Some require relatively modest test equipment; others require relatively complex and expensive mechanical equipment. Lack of standardization in test protocols and data reporting often makes comparison of data between fa

43、cilities and test conductors difficult. The goal of this Standard is to specify a battery of tests that use defined stimuli, data collection and recording methods, data analysis procedures, and data reporting requirements. Depending on the system used to measure the movement in the eyes, the test ba

44、ttery is commonly known as “Electronystagmography“ or “Videonystagmography.“ Electronystagmography (ENG) measures eye movements using the method of electro-oculography (EOG). In this method, skin-mounted electrodes measure changes in potentials across the eyeball due to movement of the eye in its so

45、cket. The corneal retinal potential is the source of the measured voltage. Videonystagmography (VNG) measures eye movements using video-oculography (VOG). In this method images of the eyes from video cameras are processed to give two dimensional (2D) or three dimensional (3D) eye position estimates.

46、 For VNG, 2D (horizontal and vertical) eye movements are typically provided, although some systems can also provide torsional eye movement estimates. Use of the Standard will greatly facilitate comparison of data among different clinical settings as well as between these data and the data from resea

47、rch laboratories. AMERICAN NATIONAL STANDARD ANSI/ASA S3.45-2009 2009 Acoustical Society of America All rights reserved 1American National Standard Procedures for Testing Basic Vestibular Function 1 Scope, purpose, and applications 1.1 Scope 1.1.1 General This Standard specifies procedures for condu

48、cting six separate tests, which, together with the data analysis and reporting requirements specified in this Standard, constitute the Basic Vestibular Function Test Battery. The six tests cover: (a) spontaneous nystagmus (see 5.2); (b) gaze-evoked nystagmus (see 5.3); (c) saccade test (see 6); (d)

49、pursuit testing (see 7); (e) positioning and positional nystagmus (see 8); and (f) caloric testing (see 9). Each of these tests evaluates a response of the vestibular system by the vestibulo-ocular reflex through the measurement of electrical signals generated by eye movements recorded by electro-oculography. 1.1.2 Subjects This Standard may be used to evaluate basic vestibular function in any human subject without restriction on age or sex. NOTE Children under the age of about 4 may not be able to participate in all tests for variou