Caloric water irrigators VNG

[holjo]

We are looking to purchase a new water irrigator for caloric testing and wondered if anyone could reccommed an irrigator that has been reliable and easy to use?

[Guy]

This is a pet subject of mine.

There isn't a water or air irrigator on the market that is not without a number of substantial design flaws, so be prepared to be frustrated and disappointed.
Manufacturers offer products designed by engineers who have never seen a patient or understand the design features experienced clinicians would regard as important.
I've built my own water irrigators so have some decent kit but I can't recommend that option as it requires an arduous formal risk assessment as well as good engineering workshop facilities.

Good luck!

[Cochlear]

I use Difra's Aquastar.
I'm very satisfied with that. It's not expensive as well.

[Guy]

Unless I am mistaken, the illustration of the Aquastar in Drifra's literature looks as though the depth of insertion into the patient's ear canal is not limited - in other words a careless slip might cause the tip to touch the TM. I think this is an important safety issue, which most manufacturers appear to overlook. My system ensures a maximum insertion depth of 20mm.

This equipment would not be suitable for those users who want to use the stimulus parameters recommended by the British Society of Audiology caloric test protocol since a flow rate of 500ml/minute is not available.

Most users would also want to warn the patient of the temperature by running the water on the pinna for a couple of seconds. The automatic timing facility of the Aquaster does not appear to allow this - but maybe Cochlear can comment on that, from personal experience.