BACKGROUND:Labyrinthitis is an inner ear disorder of unknown incidence, characterized by sudden hearing loss and concurrent vertigo.Cohort studies of patients diagnosed with labyrinthitis are nonexistent.This study aims to describe the clinical characteristics and prognosis of patients diagnosed with idiopathic labyrinthitis. METHODS:Patients with labyrinthitis in the absence of a clear viral, bacterial, or autoimmune pathogenesis were retrospectively identified from electronic patient files.Symptoms at presentation and results from vestibular testing were retrieved.The 9-item Vestibular Activity Avoidance Instrument, administered during follow-up interviews by telephone, was used to assess the presence of persistent balance problems and activity avoidance behavior.RESULTS: Sixty-one patients with idiopathic labyrinthitis were included.All patients had vestibular weakness at presentation.After a median of 61 months of follow-up (interquartile range 81), 72.5% of patients still experienced balance problems.Subjective hearing recovery only occurred in 20% of cases. CONCLUSION:Patients presenting in a tertiary dizziness clinic with idiopathic labyrinthitis have a poor prognosis for both hearing and balance function impairment.Prospective observational cohorts are required to establish objectifiable vestibular and audiological follow-up data.
This paper reviews the anatomy of the nasal cartilages and muscles. Accurate anatomical knowledge of these structures may facilitate the design of a model to study the mobility and support of the lateral nasal wall and ala and may thus provide information on the dynamics of valve area. It is concluded that a uniform description of nasal cartilages and muscles is still lacking. This is especially true for the attachments of the nasal cartilages to neighbouring structures, as well as the location and function of the muscles influencing the valve area. The use of uniform, preferably anatomical, terminology is encouraged.
Abstract Background The DizzyQuest, an app-based vestibular diary, provides the opportunity to capture the number and nature of vertigo attacks in daily life. To accomplish this, the DizzyQuest provides different strategies: event sampling using an attack questionnaire, and time sampling using an evening questionnaire. Objective of this study was to investigate whether the number and nature of reported vertigo attacks was comparable between the two questionnaires. Methods Fifty-seven patients, who reported vertigo attacks, used the DizzyQuest for on average 24 days. The number and nature (including symptoms, triggers and duration) of vertigo attacks were compared between the attack and the evening questionnaire. Results The attack questionnaire was used 192 times. In contrast, at least 749 new vertigo attacks were reported in 446 evening questionnaires. A vertigo attack was not always reported in both questionnaires during the same day. Vertigo attacks that were most likely captured by both questionnaires were not always reported the same in both questionnaires regarding triggers and duration. Conclusion Event sampling using an attack questionnaire has low recall bias and, therefore, reliably captures the nature of the attack, but induces a risk of under-sampling. Time sampling using an evening questionnaire suffers from recall bias, but seems more likely to capture less discrete vertigo attacks and it facilitates registration of the absence of vertigo attacks. Depending on the clinical or research question, the right strategy should be applied and participants should be clearly instructed about the definition of a vertigo attack.
To evaluate the natural course of recurrent vestibulopathy.Retrospective analysis.One hundred and five adult patients with attacks of vertigo without auditory or neurological symptoms.A structured interview was conducted over the telephone, 12 to 62 months after the patient's first visit to the out-patient department.Two-thirds of patients experienced spontaneous resolution of vertigo, while one-third continued to have symptoms. The diagnosis was subsequently changed to migraine in 2 per cent of patients and to Ménière's disease in 1 per cent.The prognosis for patients with recurrent vestibulopathy is good. In a few cases, the diagnosis is provisional and will be subsequently changed to migraine or Ménière's disease.
We conducted a study to determine the causes of dizziness in patients aged 70 years and older who had been referred to our multidisciplinary dizziness clinic between Nov. 1, 2000, and Dec. 31, 2008. This population was made up of 731 patients--254 men (34.7%) and 477 women (65.3%). During their consultations, all of these patients were evaluated simultaneously by an ENT surgeon and a neurologist. We were able to identify the cause of dizziness in 620 of these patients (84.8%). The two most common causes were benign paroxysmal positional vertigo (BPPV), which was found in 202 patients (27.6%), and hyperventilation/anxiety, which was diagnosed in 112 patients (15.3%). Based on our findings, we conclude that the cause of dizziness can be established in the vast majority of elderly patients. We also compare our findings in these older patients with those of a group of 2,556 younger patients who were seen at our hospital and with the findings reported in other studies.
