---
name: audio-vestibular-assessment
description: Use when asked to administer, score, or explain an Audio-Vestibular Assessment — combined audiology and balance evaluation using WHO hearing-loss grading and the Dizziness Handicap Inventory (DHI) — grounded in FormExamples/form-examples; related to audiology-assessment and hearing-aid-assessment.
---

# Audio-Vestibular Assessment

Combined audiology and vestibular (balance) assessment capturing
presenting symptoms, otoscopic and audiometric findings, tympanometry,
vestibular screening tests, and the Dizziness Handicap Inventory (DHI)
to classify hearing loss severity and quantify vestibular handicap.

## Scoring

**Instruments:** Pure-tone audiometry (WHO hearing-loss grades) +
Dizziness Handicap Inventory (DHI).

- **WHO hearing loss:** Normal (< 20 dB HL), Mild (20–34), Moderate
  (35–49), Moderately Severe (50–64), Severe (65–79), Profound (≥ 80).
- **DHI:** No handicap (0–16), Mild (18–36), Moderate (38–52), Severe
  (54+).

## What it covers

Demographics; presenting symptoms; otoscopic examination; pure-tone
audiometry (air and bone conduction); speech audiometry; tympanometry
and acoustic reflexes; vestibular screening (Head Impulse Test,
Dix-Hallpike, Romberg); the Dizziness Handicap Inventory; and clinical
impression with referral.

## Common pitfalls

- **Assessing hearing and balance in isolation** — the two systems
  share anatomy (the inner ear) and often co-present; a combined
  assessment exists specifically to avoid missing a vestibular cause
  behind a hearing complaint or vice versa.
- **Skipping Dix-Hallpike when BPPV is a plausible cause of reported
  dizziness** — a common, treatable cause of positional vertigo is
  easily missed without the specific provocative test.
- **Treating DHI as a hearing measure** — it quantifies the functional
  *handicap* from dizziness, not hearing loss; the two scores answer
  different questions and shouldn't be conflated.

## Learn more

- [FormExamples: audio-vestibular-assessment](https://github.com/FormExamples/form-examples/tree/main/forms/audio-vestibular-assessment) for the full implementation, clinical references, and worked examples.
- [[audiology-assessment]], [[hearing-aid-assessment]] for related hearing assessments.