Bobby R Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, U.S.A.
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, U.S.A.
Laryngoscope. 2021 Jun;131(6):1382-1385. doi: 10.1002/lary.29487. Epub 2021 Feb 26.
OBJECTIVES/HYPOTHESIS: To determine the value of standard clinic screening questions and vital signs in predicting abnormal vestibular function, indicated by standard objective diagnostic tests.
Retrospective records review.
We reviewed electronic medical records of 150 patients seen by the neurotologists or the physician assistant they supervised, in an out-patient tertiary care clinic, between June 2018 and March 2020, and subsequently referred for the complete objective vestibular test battery (VB).
Of standard questions asked during the initial exam about vertigo, disequilibrium, lightheadedness and oscillopsia, only vertigo predicted an abnormal response on the VB. More males than females had abnormal VB responses, P < .05. Pulse was not related to VB score. Significantly more subjects with blood pressure in the range for stage 2 hypertension (blood pressure [BP] stage 2) had abnormal than normal results on the VB, P < .00001. Subjects with BP stage 2 had high rates of diabetes (34.2%) and hypertension (68.4%) as diagnosed by their primary care physicians or cardiologists.
Complaints of subjective vertigo and BP in the range of hypertension stage 2 are most likely to predict abnormal findings on the VB. Therefore, during an examination of a patient who comes in complaining of dizziness, two measures may be the most useful for screening: BP in the range of hypertension type 2, when BP is taken by a nurse, and a question to determine whether or not the patient has true vertigo.
3 Laryngoscope, 131:1382-1385, 2021.
目的/假设：确定标准临床筛查问题和生命体征在预测异常前庭功能方面的价值，异常前庭功能由标准客观诊断测试确定。
回顾性病历回顾。
我们回顾了 2018 年 6 月至 2020 年 3 月间在一家门诊三级保健诊所由神经耳科医生或他们监督的医师助理看诊的 150 名患者的电子病历，随后这些患者被转介进行完整的客观前庭测试（VB）。
在最初的检查中，询问了关于眩晕、不平衡、头晕和眼球震颤的标准问题，只有眩晕预测 VB 异常反应。男性异常 VB 反应的比例高于女性，P<.05。脉搏与 VB 评分无关。血压处于 2 期高血压范围内的患者 VB 异常的比例显著高于正常，P<.00001。血压处于 2 期高血压范围的患者患有糖尿病（34.2%）和高血压（68.4%）的比例较高，这些诊断由他们的初级保健医生或心脏病专家做出。
主观眩晕和高血压 2 期范围内的血压抱怨最有可能预测 VB 的异常发现。因此，在对抱怨头晕的患者进行检查时，两种措施可能是最有用的筛查方法：由护士测量的高血压 2 期范围内的血压，以及一个确定患者是否有真正眩晕的问题。
3 级喉镜，131：1382-1385，2021。
