Chua Kenneth Wei De, Yuen Heng Wai, Low David Yong Ming, Kamath Savitha Hosangadi
Department of Otorhinolaryngology-Head and Neck Surgery, Changi General Hospital, Singapore.
The American Institute of Balance (AIB), Largo, FL, USA.
J Otol. 2022 Jan;17(1):5-12. doi: 10.1016/j.joto.2021.06.003. Epub 2021 Jun 26.
Patients with dizziness may present with symptoms of tilting, swaying, rocking, floating or with disequilibrium. This may be suggestive of an isolated otolithic dysfunction yet, there is little emphasis on this emerging clinical entity. To characterize and describe the prevalence of isolated otolith dysfunction in a local tertiary hospital and correlate them with clinical diagnosis.
Retrospective medical chart review of patients who presented with dizziness to the specialist outpatient Otolaryngology clinic, who required vestibular laboratory investigation.
Of the 206 patients, more than half of them (52.4%) fulfilled the criteria for either probable or definite isolated otolith dysfunction. When there are clinical symptoms of otolith dysfunction reported, there is a 1.62 odds of a remarkable laboratory otolith finding. The most common clinical finding was "no clear diagnosis" (65.5%) followed by Vestibular Migraine (13.6%).
The prevalence of isolated otolith dysfunction is quite high. Laboratory tests of otolith function should be performed more routinely. This can be done in a sequential way to optimize cost effectiveness in countries with no insurance reimbursement. Prospective cohort studies on isolated otolith dysfunction, will lay the groundwork for achieving diagnostic consensus and formulating rehabilitation plans to aid this group of patients.
头晕患者可能会出现倾斜、摇晃、摆动、漂浮的症状或存在平衡失调。这可能提示孤立性耳石功能障碍，但目前对这一新兴临床实体的关注较少。本研究旨在描述一家当地三级医院中孤立性耳石功能障碍的患病率，并将其与临床诊断相关联。
对到耳鼻喉科专科门诊就诊且需要进行前庭实验室检查的头晕患者进行回顾性病历审查。
在206例患者中，超过一半（52.4%）符合可能或明确的孤立性耳石功能障碍标准。当报告有耳石功能障碍的临床症状时，实验室耳石检查有显著发现的几率为1.62。最常见的临床诊断是“未明确诊断”（65.5%），其次是前庭性偏头痛（13.6%）。
孤立性耳石功能障碍的患病率相当高。应更常规地进行耳石功能实验室检查。在没有保险报销的国家，可以按顺序进行检查以优化成本效益。对孤立性耳石功能障碍进行前瞻性队列研究，将为达成诊断共识和制定康复计划以帮助这组患者奠定基础。
