Polaczkiewicz Laura, Olszewski Jurek
Klinika Otolaryngologii, Onkologii Laryngologicznej, Audiologii i Foniatrii, II Katedry Otolaryngologii Uniwersytetu Medycznego w Łodzi.
Otolaryngol Pol. 2019 Sep 10;74(2):23-30. doi: 10.5604/01.3001.0013.4374.
The aim of the study was to attempt to analyze the most common causes leading to dizziness, vertigo and balance disorders according to gender and age.
Analysis of medical records and evaluation of VNG tests were performed on 608 patients of the private ENT practice "VERTIGO" in Opole between 2011 and 2017, including 404 women and 204 men. The patients' age was in the range from 18 to 85 years, average age 49.88 years. The following parameters were taken into account in the analysis: the result of the subjective examination and the basic ENT and otoneurological examination, videonystagmographic examination, hearing assessment (tonal and impedance audiometry) and imaging tests (head MRI/CT and cervical spine x-ray), assessment of doppler ultrasound examination of vertebral arteries flow.
In examinations patients dizziness and vertigo were more common in women (66.45%) than men (33.55%), the most numerous was group of patients over 60 years, i.e. 30, 76%, systemic ver-tigo predominated (61.02%). Hypertension was the most common chronic disease in the entire popu-lation of patients with dizziness, vertigo and balance disorder and its frequency increases with age, which translates into an increase in the frequency of non-systemic and mixed dizziness reported by patients. The frequency of lipid metabolism disorders increases statistically significantly with age, while thyroid dysfunction as well as migraines and frequent headaches are significantly more com-mon in women reporting dizziness, vertigo and balance disorder than in men. In doppler ultrasound examination, while with age the frequency of bilateral disorders in vertebral artery flow increases significantly. The percentage of individual diagnoses in the examined patients was as follows: ves-tibular disorder (35.86%), benign paroxysmal positional vertigo (18.9%), mixed vertigo (16.12%), cervical vertigo (5.42%), Méniére's disease and its suspicion (5.1%), vertigo and dizziness of central origin (3.78%), vascular vertigo (2.8%), vestibular neuritis (2.3%), post-traumatic dizziness (1.32%) and the cerebellopontine angle tumors (0.16%). In the VNG study: in visual-oculomotor tests an in-crease in the percentage of pathology with age between 51 and 60 years old.
The structure of diagnoses made in private practice differs from public health care. This results from the fact that the patient with acute symptoms first goes or is transported to the hospital emergency department. The second reason is the cost of diagnostics in the private sector which is not affordable to every patient.
本研究旨在尝试根据性别和年龄分析导致头晕、眩晕及平衡障碍的最常见原因。
对2011年至2017年间在奥波莱的“VERTIGO”私立耳鼻喉科诊所就诊的608例患者的病历进行分析,并对其进行视频眼震图(VNG)测试评估,其中包括404名女性和204名男性。患者年龄在18至85岁之间,平均年龄49.88岁。分析中考虑了以下参数:主观检查结果、耳鼻喉科和耳神经科基本检查、视频眼震图检查、听力评估(纯音和阻抗测听)及影像学检查(头部MRI/CT和颈椎X光)、椎动脉血流多普勒超声检查评估。
在检查中,头晕和眩晕在女性患者中(66.45%)比男性患者中(33.55%)更为常见,60岁以上患者群体数量最多,即占30.76%,全身性眩晕占主导(61.02%)。高血压是所有头晕、眩晕及平衡障碍患者中最常见的慢性病,其发生率随年龄增长而增加,这导致患者报告的非全身性和混合性头晕发生率上升。脂质代谢紊乱的发生率随年龄增长有统计学显著增加,而甲状腺功能障碍以及偏头痛和频繁头痛在报告头晕、眩晕及平衡障碍的女性中比男性更为常见。在多普勒超声检查中,椎动脉血流双侧紊乱的发生率随年龄增长显著增加。所检查患者的各诊断百分比情况如下:前庭障碍(35.86%)、良性阵发性位置性眩晕(18.9%)、混合性眩晕(16.12%)、颈性眩晕(5.42%)、梅尼埃病及其疑似病例(5.1%)、中枢性眩晕和头晕(3.78%)、血管性眩晕(2.8%)、前庭神经炎(2.3%)、创伤后头晕(1.32%)以及桥小脑角肿瘤(0.16%)。在VNG研究中:在视觉眼动测试中,51至60岁年龄段病理情况的百分比随年龄增加。
私立诊所做出的诊断结构与公共卫生保健不同。这是由于出现急性症状的患者首先前往或被送往医院急诊科。第二个原因是私立部门的诊断费用并非每个患者都能承受。