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On “The Influence of Otolith Dysfunction…” Murray et al. Phys Ther. 2007;87:143–152.

Murray and colleagues1 are to be commended for their attempt to identify the role of the otolith organs in the clinical presentation of patients with unilateral vestibular disorders. With the advent of the subjective visual horizontal (SVH), subjective visual vertical (SVV), and vestibular evoked myogenic potential (VEMP) tests, it has become feasible to assess otolith function as a component of the vestibular function test battery. How the otolith organs influence symptoms, clinical signs, and recovery is not known and is a valid question.

Murray and colleagues attempted to address this question by assessing both physical performance measures and self-report measures of symptom intensity and the impact of those symptoms in patients with either combined semicircular canal and otolith disorders or semicircular canal–only disorders. As the authors noted, this study was predicated on the ability to correctly classify these 2 groups of patients, and this is where the study suffers.

First, with the exception of benign paroxysmal positional vertigo (BPPV) …