VertiPACS® is designed for use in the ENT or neurology practice as well as in the clinical or research setting.
VertiPACS® is the integrated software platform for all the entire ZEHNIT vestibular product range. It offers a complete arsenal of tests and procedures as well as a rich set of editing and documentation tools. Its basic features are:
The easy-to-use database makes creating and retrieving patient files child‘s play.
Examinations and assessments do not necessarily happen in the same room. VertiPACS® allows the same patient file to be accessed from different locations.
Patient master data and examination results can be transmitted with this protocol. The latest GDT version (3.1) is supported.
Reports and summaries can be created as printouts or PDF files. Your own logo can be integrated to enhance your corporate identity.
Editing and playback
Some test results require a closer look and sometimes even some editing to smooth out artefacts and make the result more clear-cut. Every test can be edited and played back with the corresponding video material.
VertiPACS® controls all ZEHNIT hardware devices, including VertiGoggles®, VertiPlatform®, VertiChair® and VertiSVV®.
Interface to VertiApps
This interface is used to exchange patient master files, videos and raw data from measurements with the VertiMobile® app as well as completed questionnaires with the VertiQuest® app.
This function allows the systematic collection and recording of a patient‘s dizziness history. This step can thus be delegated.
Here you can document and supplement findings from ear exams, vestibulospinal tests, vision exams, blood tests and other exams.
Often, images are taken during the vertigo diagnosis process. Such images include photos of the eardrum taken during otoscopic examinations or images of the fundus of the eye taken with an ophthalmoscope, or X-ray films. These images and of course PDF files can be saved to the patient database and printed as part of the report.
Dizziness Handicap Inventory
When this well-known questionnaire is used with VertiPACS®, the program calculates the score and subscores and instantly generates a result. Using VertiQuest®, a patient can even do this test independently of a doctor.
This test is used to calibrate the distance between the patient‘s eye and the beam splitter mirror of the video goggles.
This test is performed to document gaze dependent spontaneous nystagmus, au-tomatically calculating its direction and severity.
This test is designed to document posi-tion-dependent nystagmus, which fre-quently presents in patients suffering from atypical BPPV or central nervous system disorders.
This test is designed for the diagnosis of BPPV. It can be used for dynamic posi-tional testing of the semicircular canals and to document repositioning treatment of patients suffering from BPPV.
The classic test of the labyrinth. In addition to the analysis of spontaneous nystagmus, the results of the irrigations are displayed in the familiar culmination and Freyss diagrams, thus allowing diag-noses at a glance. The numeric values of Slow Phase Velocity (SPV), Vestibular paresis, Directional Preponderance and the Fixation Index are calculated and shown in a table.
This feature allows users to freely con-figure their own VNG tests to be used separately or together with other tests as part of a test protocol.
This test is used to calibrate the distance between the
patient‘s eye and the beam splitter mirror of the video goggles.
The Head Impulse test (HIMP) enables a sidedependent evaluation of all six semi-circular canals. In the test result the head trace can be superimposed on or mir-rored with the eye trace. It is also possi-ble to mirror the diagram for the left ear. The playback function allows simultan-eous playback of the eye video and the head and eye traces in the position and velocity domain.
The SHIMP (Suppression Head Impulse test) is a new variant of the Head Impulse test. It lets you see whether and to what degree any residual function remains on the affected side. The patient‘s task is to stare at a built-in LED which is used as a fixation target during the test to prevent covert saccades (“saccade-killer”). The completely light-proof and magnetically held eye cover facilitates the test.
The diagnosis of peripheral and central disorders requires a systematic examin-ation of the different types of eye move-ments. For an analysis it is necessary to detect horizontal, vertical as well as tor-sional eye movements.
The detection of torsional eye move-ments is performed in the following tests:
» Gaze Test
» Position Test
» Positioning Test
» Custom Test
For research and instructional purposes, measured values and videos can be sto-red as separate files on the local hard disk or on an external data storage device:
» Goggles video – Eye video recorded in MP4 format during testing
» Scene video – Room video recorded in MP4 format during testing
» Data – ASCII test results formatted in a CSV file (comma separated values)
The videos are played back with standard media players. Exported measurement data can be used with programs such as Excel or MatLab.
Dizziness caused by a malfunctioning of the optokinetic system is indicative of a central nervous system disorder. This test allows an examination of the optokinetic system using various stimuli in the horizontal and vertical planes.
Disorders of the pursuit system can be detected with this test. It enables an examination of the pursuit system with horizontal and vertical stimuli at four velocities. The horizontal and vertical stimuli have a fixed amplitude of ±15° and ±10°, respectively.
The test allows the assessment of the saccade system via horizontal and vertical stimuli with an amplitude of between ±5° and ±30°. They alternate directions and are equal in number. Speed, precision and latency are assessed, along with the number of trials, error saccades, valid saccades and express saccades.
This test is performed to detect gaze dependent nystagmus. The duration of the measurement, the step duration and step amplitude horizontal and vertical can be set by the user.
The patient’s eyes pursue a vertical, sinusoidal gaze target, which is contin-uously presented in a sequence of four frequencies. After each frequency there is a short pause and the gaze target briefly remains in the zero position. The viewer’s anticipation directs the eye in the expected direction and then back again to the gaze target (zero position). The vertical, sinusoidal stimuli have an amplitude of ±10° and are presented in each test run at four velocities, 0.1Hz, 0.3Hz, 0.5Hz and 0.7Hz.
Variant of the Smooth Pursuit test in which the initial saccade is suppressed by a short jump of the fixation target. To assess the onset of Smooth Pursuit, unpredictable step ramp stimuli with various jumps and speeds are used. The amplitudes of the jumps vary between ±5° and ±10°, the velocities between 15°/s and 25°/s.
Advanced Saccades allow a detailed assessment of almost every part of the brain and so allow a kind of „brain mapping” with a sensitivity that can, in certain cases, be higher than that of an MRI.
A fixation target at the zero position is switched off, after which a new target appears randomly with an amplitude of either ±10° or ±20° in the horizontal direction.
During the presentation of the horizontal gaze target, the fixation target at zero position remains for a short time. The direction of the horizontal gaze target is random, with an amplitude of either ±10° or ±20°.
This test is used for the separate asses-sment of reflexive saccades (prosacca-des) and voluntary saccades (antisacca-des). When the visual stimulus is presented, the patient is asked to look at a point mirroring the position of the stimulus. The stimulus is horizontal with a random direction and amplitudes of ±10° and ±20°.
This are saccades generated in antici-pation of the appearance of a target at a particular location. In this test, the ampli-tude of the visual target is always ±20°, and the horizontal target jumps in a regular sequence. After a short period of getting used to the stimulus, the patient can perform the saccade even before the new visual target appears, due to the internal image of the saccade (efference copy).
This test assesses the patient’s ability to generate a saccade to a location in which a target has been previously present. The direction and amplitude of the horizontal stimulus are random. The amplitudes are ±10° and ±20°.
The VertiPlatform® allows a quantifica-tion of the Romberg test. VertiPlatform® is a force plate with pressure-sensitive sensors to determine the centre of pres-sure (COP), the oscillations of the body as well the loss of stability (LOS). The results are displayed in a 2D bar graph (stabilo-gram) and a sway frequency diagram (Fourier Analysis). Posturography is a means to assess dysfunctions of the ves-tibular system on the cerebellar, spinal and vestibular level.
The balance training consists of a Rom-berg test as basic test and 4 to 6 exer-cises which can be used for the therapy of any kind of balance disorder. Following instructions and guidance on a flat screen, the patient endeavours to control his centre of pressure. This feedback method increases the patient‘s motiva-tion and accelerates the progress of compensation of vestibular deficits.
Limits of Stability
This test is used to define the extent to which the patient can move and control his centre of pressure without losing his balance. The patient’s task is to shift his centre of gravity in a controlled manner in the direction of a target: forwards, forwards right, right, backwards right, backwards, backwards left, left, forwards left.
Subjective Visual Vertical
VertiSVV® enables the determination of both the Subjective Visual Vertical and the Subjective Visual Horizontal. In ad-dition to the classic protocol, which has the patient in a fully upright position, tests can be performed in up to 12 tilt positions per side to assess the func-tioning of the utricle and saccule at the same time. The test results are displayed as a graph and in a table with the mean value and standard deviation computed.
The test result can be displayed either in a relative diagram alone or as a combi-nation of relative and absolute diagrams.
VertiChair® is a multi-purpose rotary chair system for the diagnosis and treat-ment of vestibular disorders. Its powerful step engines allow the subject to be turned in the pitch and yaw plane at the same time, providing a unique range of motion. Its motor-driven sled can even move the subject out of the yaw axis to enable eccentric rotations.
The chair is controlled by VertiPACS®, the integrated software for all ZEHNIT vesti-bular products.
The system can be position-driven and velocity-driven. It lets the user perform all major vestibular procedures and tests, including standard and user-defined pro-cedures for the diagnosis and treatment of BPPV. The preset procedures are:
Classical Rotary Chair Tests
» Impulse Acceleration Test
» Constant Acceleration Test
» Sinusoidal Acceleration Test
» Sinusoidal Harmonic Acceleration Test
» Velocity Step Test
Unilateral Centrifugation (VertiSVV®)
This test is performed to assess the function of each utricle separately. First, the seated patient is rotated on the vertical axis until the chair reaches its final velocity. Then the chair is moved a few centimetres to the side, just enough to bring one utricle into the centre of the rotation. Now the function of the other utricle can be assessed, either through a Subjective Visual Vertical (SVV) test or by means of 3D oculography. Acceleration, velocity, offset and number of repetitions can be set.
This test offers the same test parameters as the test described above. The eye mo-vements are tracked via the VertiGog-gles®.
BPPV Chair test
This is a rotary chair test for the diagnosis of BPPV. In addition to diagnostic uses, it allows the treatment of all kinds of BPPV. Predefined and user-defined procedures can be performed to determine and utilize the most effective treatments.
The multi-purpose rotary chair system VertiChair® is currently only available in countries that accept CFDA approval.