Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- vertigo
- hearing loss
- tinnitus
- aural fullness
- drop attacks
Other diagnostic factors
- positive Romberg's test
- Fukuda's stepping test
- bilateral symptoms
- nystagmus
- tandem walk
Diagnostic investigations
1st investigations to order
- pure-tone air and bone conduction with masking
- speech audiometry
- tympanometry/immitance/stapedial reflex levels
- oto-acoustic emissions (OAE)
Investigations to consider
- electrocochleography
- electronystagmography
- rotary chair test
- vestibular-evoked myogenic potential (VEMP)
- MRI of internal auditory canals
- thyroid function tests
- Lyme disease and syphilis serology
- anti-nuclear antibody
- anti-neutrophil cytoplasmic antibody
- rheumatoid factor
Treatment algorithm
Contributors
Authors VIEW ALL
Otology-Neurotology
Ear Nose and Throat Associates of New York
New York
NY
Disclosures
SNG declares that she has no competing interests.
Professor Emeritus of Audiology
Department of Communication Sciences and Disorders
Steinhardt School of Culture, Education, and Human Development
New York University
Specialist in Forensic and Occupational Audiology
New York
NY
Disclosures
MHM declares that he has no competing interests.
Peer reviewers VIEW ALL
Associate Professor of Otology and Laryngology
Harvard Medical School
Boston
MA
Disclosures
SDR declares that he has no competing interests.
Professor
Otolaryngology/Head and Neck Surgery
The New York Eye and Ear Infirmary
Surgeon Director
New York
NY
Disclosures
CJL declares that he has no competing interests.
Consultant ENT Surgeon
Leicester Royal Infirmary
Leicester
UK
Disclosures
PR declares that he has no competing interests.
Clinical Senior Lecturer & Consultant in Audiovestibular Medicine
Ear Institute
University College London
London
UK
Disclosures
DEB declares that she has no competing interests.
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