AB127. SOH22ABS073. A retrospective review of objective vestibular testing of patients with subjective dizziness: what proportion are truly due to peripheral vestibular pathology?

Background: Dizziness, vertigo or imbalance can be due to dysfunction of the peripheral and/or the central vestibular system. Both a thorough clinical history and a careful bedside examination are critical for differential diagnoses. In a select cohort of patients, a diagnosis of peripheral vestibular pathology cannot be adequately identified, and objective vestibular testing plays a pivotal role in arriving at a diagnosis. Determination of surgical or rehabilitative treatment options depends on an accurate diagnosis.

Methods: A retrospective review of 200 objective audio-vestibular assessments referred from a single otologist’s clinic over a 4-year period was carried out. Up to 1,300 patients presenting with vertigo were reviewed during this time frame from a specialised vertigo clinic. Access times, patient demographics, and assessment outcomes were collated.

Results: The mean waiting time from referral to assessment was 35 days. The patients’ age ranged from 19–90 years, and the mean was 53 years of age. The male:female ratio was 1:3. Fifty percent of vestibular assessment results were indicative of a peripheral vestibular hypofunction. Approximately 25% were reported to be normal, 15% mixed, 10% central, and 5% other.

Conclusions: Objective audio-vestibular assessment is key to the diagnosis of vertigo symptoms pertaining to an otological source, in patients in whom history and clinical examination alone did not reveal an obvious pathology. Audio-vestibular testing outcomes proved beneficial in planning vestibular rehabilitation or surgical intervention, particularly in more complex cases where a central, visual, neuro-ophthalmological, or migraine component was suspected.

Keywords: Dizziness; otology; rehabilitation; vertigo; vestibular