A retrospective study on the prevalence of isolated otolith dysfunction
in a local tertiary hospital
Abstract
Objective: 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. Design:
Retrospective medical chart review of patients who presented with
dizziness to the specialist outpatient Otolaryngology clinic, who
required vestibular laboratory investigation. Results: 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%). Conclusion: 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.
Keywords: Vestibular disorders, balance, equilibrium, otolith
dysfunction, vestibular-evoked myogenic potential.