Last reviewed: 28 Jun 2021
Last updated: 30 Jul 2020

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • vertigo
  • dizziness
  • nausea and vomiting
  • hearing loss
  • otorrhoea

Other diagnostic factors

  • nystagmus
  • tinnitus
  • vertigo-related quick head or body movements
  • influenza-like symptoms
  • otalgia

Risk factors

  • viral infections
  • chronic suppurative otitis media
  • acute otitis media
  • cholesteatoma
  • meningitis
  • inner ear malformations
  • autoimmune ear diseases
  • syphilis

Diagnostic investigations

Investigations to consider

  • CT or MRI brain
  • electronystagmography
  • rotary chair test
  • vestibular-evoked myogenic potentials
  • syphilis serology
  • cerebrospinal fluid Gram stain and culture
  • serum HIV rapid test
  • basic metabolic profile (including urea and creatinine)

Treatment algorithm

Contributors

Authors

Brandon Isaacson, MD, FACS
Brandon Isaacson

Professor

Department of Otolaryngology-Head & Neck Surgery

University of Texas Southwestern Medical Center

Dallas

TX

Disclosures

BI is an author of a reference cited in this topic.

Peer reviewers

Marc Bennett, MD

Associate Professor

The Otology Group of Vanderbilt

Nashville

TN

Disclosures

MB declares that he has no competing interests.

Joni K. Doherty, MD, PhD

Assistant Professor 

Neurotology Otolaryngology-Head & Neck Surgery

USC Keck School of Medicine

San Diego

CA

Disclosures

JKD declares that she has no competing interests.

Iain Swan, MD, FRCS

Senior Lecturer in Otolaryngology

Honorary Consultant Otolaryngologist

Glasgow Royal Infirmary

Glasgow

UK

Disclosures

IS declares that he has no competing interests.

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