Prevalence of Vestibular Dysfunction with Presbycusis among Elderly in Malaysia

Objectives: This study aims to determine the prevalence of vestibular dysfunction in the Malaysian elderly and its association with presbycusis, age and other associated risk factors. Methods: A cross-sectional study was undertaken in a tertiary otorhinolaryngology department and the community. Adults aged 60 years and above who attended the ORL CLINIC with or without presbycusis were invited to participate. The main outcome measures, including the Malay Version Vertigo Symptoms Scale, pure tone audiometry and vestibular assessment, were obtained using a Video Head Impulse Test (VHIT). Results: The prevalence of vestibular dysfunction with presbycusis in the study population of 135 participants was 46.7 per cent (95 per cent confidence interval, 24.0 to 36.2 per cent). The median age was 68 years (range, 60–86 years). The A chi-square test of independence showed that there was significant association between Presbycusis and Tinnitus, X2 (1, N = 135) = 97.37, p < .001. A chi-square test of independence was performed to examine the relation between presbycusis and dizziness. The relation between these variables was significant, X2 (2, N = 135) = 28.42, p < .001. A chi-square test of independence showed that there was no significant association between presbycusis and VHIT, X2 (1, N = 135) = .01, p = .938. Conclusion: Vestibular dysfunction is independently associated with ageing and presbycusis. More research investigating the advantages of additional screening for vestibular dysfunction in older presbycusis patients is needed. Key words: Elderly; Presbycusis; Vestibular dysfunction; Video Head Impulse Test (VHIT)

Acute vertigo in the ENT emergency

Summary Introduction: Acute vertigo ranks among the common reasons for visiting the emergency department. The aim of this study was to evaluate the rate of peripheral vestibular syndrome (PVS) in patients with acute vertigo examined at the ENT emergency department and to compare the agreement of physical ENT examination with video-assisted vestibular testing. Methods: Patients eamined at the ENT emergency department from January to December 2019 were evaluated retrospectively. The patients who underwent basic ENT examination without video-assisted vestibular testing form group A. The patients who underwent basic ENT examination which was followed by video head impulse test (vHIT) and videonystagmography in the next four days form group B. Results: A total of 117 patients with acute vertigo were included in group A, PVS was found in 31 patients (27%). In total, 50 patients were included in group B; PVS was found in 15 patients (30%), vestibular neuronitis was dia­gnosed most often (10 patients). The difference in the dia­gnosis of PVS by basic ENT examination (27 patients, 54%) and by video-assisted vestibular testing (15 patients, 30%) was statistically significant (P = 0.0030). The gain of the lateral (P = 0.0101) and superior (P = 0.0043) semicircular canal proved to be statistically significant, while vHIT was lower in PVS in comparison to other causes of vertigo. Conclusion: After basic ENT examination, PVS as a cause of acute vertigo was dia­gnosed in 27%. Video-assisted vestibular testing proved a statistically significant lower incidence of PVS in comparison to basic ENT examination. Accessibility of video- -assisted vestibular testing in the emergency department might allow for higher accuracy in the dia­gnosis of acute vertigo. Key words acute vertigo – vestibular function tests – video head impulse test – videonystagmography