Efficacy of evaluation in different cochleovestibular disorders

Authors

Dr.med. Ágnes Szirmai (Budapest, Hungary)
Dr. Anna Deme (Budapest, Hungary)

Proceedings

ASN - Volume 8 - 2014

Topics

Sensology
Hearing
Diseases
Neurootology
Equilibrium
Diseases
Neurootology
Equilibrium
Equilibriometric tests
Neurootology
Equilibrium
Sensology
Hearing
Neurootology

Keywords

complex evaluation, sensorioneural hearing loss, Vertigo, vestibular disorders.

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Abstract

Abstract:
The complete evaluation of cochleovestibular symptoms is a long process. The average cost associated with the full diagnostic evaluation is very high, while the diagnostic impact of these tests is extremely low. The diagnosis of the sensorineural hearing loss and vertigo is easy with the audiometrical and otoneurological examination, but in most cases the exact cause remains unknown. Authors examined the pathological ratio of laboratory tests, neurological, ophthalmological examinations and imaging methods in different cochleovestibular disorders. The patients were treated with corticosteroid, or different vasoactive drugs, and were later divided retrospectively into 7 diagnostic groups according to the indication of the therapy: sudden sensorineural hearing loss (SSNHL), acute impairment of chronic sensorineural hearing loss (AICSNHL), chronic sensorineural hearing loss (CSNHL), tinnitus with normal hearing, Ménière’s disease, central vestibular lesion, and peripheral vertigo. When analyzing the main laboratory findings in several groups, mostly normal results occurred. The BERA seems to be informative only in selected cases; the ratio of the pathological responses was only 30%. The routine neurological examinations were pathological in 17% of the patients. The referral to the neurologist must be targeted, or the patients need a specially educated neurologist. The ratio of the pathological findings was 29.6% in the CT examinations, and 43.8% in the MRI scans. This means that the MRI is more sensitive than the CT scan. Our opinion is that schematic evaluation of the disorders based on a routine check-list is time and money consuming. A more targeted evaluation, after the case-history and cochleovestibular examination, seems to be more economical.