Whose Idea Was This?
The Story of Robert Bárány (1876-1936)
Written by Erica Zaia, Audiologist
As an audiologist who specializes in vestibular assessment, I have done many caloric tests over the years. I know that, despite understanding the procedure and its undeniable importance, most patients dislike the experience of having water put into their ear canals. It is not uncommon for me to hear this procedure called “the torture test.” While testing Muriel Kauffmann, Balance & Dizziness Canada co-founder and past president, I was asked the most intelligent question yet about calorics: “Whose idea was this? How was it discovered?”
Muriel was right when she suspected it must have taken someone with a lot of curiosity and observance to conclude that a change in temperature in the ear canal would stimulate the vestibular organ in the inner ear, producing not only vertigo but also a response translated into eye movement called nystagmus. This caloric test is still the only test available in the clinician’s arsenal to assess the semicircular canals of the right and left ears separately, allowing analysis in terms of responsiveness and symmetry of the balance organs.
Undoubtedly, Dr. Robert Bárány, who did discover the value of this procedure, was brilliant. He was subsequently recognized by the Royal Caroline Institute, which awarded him the Nobel Prize in Physiology or Medicine in 1914. Dr. Bárány was born in Vienna in 1876, of Jewish descent. His father was a farm manager and his mother was the daughter of a respected Prague scientist. His mother’s intellectual interests were a strong influence on Robert, the eldest of six children.
When Bárány graduated as a Doctor of Medicine, he pursued the specialty of Neuro-otology at the University of Vienna. At that time, patients with wax build-up would have their ears syringed with water. As Dr. Bárány explained in his Nobel Lecture, “a number of them complained afterwards of vertigo.” Knowing the eyes’ response to vertigo, Dr. Bárány examined his patients’ eyes and noted his findings. He continued observing and listening to them until one commented about how warmer water made him dizzier. Dr. Bárány then conducted experiments comparing responses to colder and warmer water, which is still what clinicians around the world routinely do now, a hundred years later.
The Bárány Society, an international society for Neuro-otology, was founded in 1960 in order to honor the memory of the late Robert Bárány.
If you want to know more about this gifted scientist, who was finally released from a Russian prisoner-of-war camp in order to receive his Nobel Prize two years after his award was issued, visit the Nobel Prize’s website.