(OM) Department of Neurology, The Johns Hopkins School of Medicine, Baltimore, Maryland; (DRG) Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland
Subject
Pinched Nose Valsalva
Description
Valsalva (closed glottis or pinched nose): instruct the patient to take a deep breath and ‘bear down' (closed glottis) or take a deep breath and ‘try to pop their ears' (pinched nose). Assess for nystagmus. In superior canal dehiscence, pressure changes may be transmitted to the superior canal, causing an excitatory pattern of nystagmus with the nose pinched (https://collections.lib.utah.edu/details?id=1307322&q=valsalva&fd=title_t%2Cdescription_t%2Csubject_t&facet_setname_s=ehsl_novel_gold), or an inhibitory pattern with Valsalva against a closed glottis.
