Effects of timely otolaryngological/audiological intervention on patients with acute vertigo due to peripheral vestibular disorders

Abstract

Vertigo is the presenting symptom of some peripheral vestibular disorders, like Benign Positional Vertigo (BPV), Ménière's disease, and vestibular neuritis, and for many other clinical conditions as well. Some clinicians from the Christchurch Public Hospital suspect that there is a significant need to improve the diagnostic accuracy and overall management of patients presenting with complaints of "acute vertigo or dizziness", especially BPV and Ménière's disease. The final diagnosis of many such patients treated for these conditions in the past has been suspected to be somewhat incomplete or inappropriate. These patients were commonly referred to various other departments, where they underwent a number of investigations, particularly medical imaging [head CT (Computed Tomography) / MRI (Magnetic Resonance Imaging) scans, which were in many cases not necessary. Such delays in the process led to an extra or unnecessary burden on the limited health funds available to the hospital or to the patient. Another drawback was an elevated patient stress and anxiety as critical time was lost with the increased number of admissions, or in transferring the patient between various departments without any conclusive diagnosis and treatment. It was proposed to conduct a retrospective study on the accuracy of diagnosis of those patients admitted to Christchurch Public Hospital with complaints of acute vertigo, particularly for suspected peripheral vestibular disorders (mainly BPV and Ménière's disease) over the period of 2004-2005. Implementation of a more specific and detailed management approach at the level of the initial clinical examination or diagnostic investigations (specifically, by an early Otolaryngology/Audiology intervention) was planned for the year 2006. The two groups of patients (2004-2005 and 2006) were compared to verify the final achievements concerning the diagnostic accuracy and at various other levels with the newly implemented changes in 2006.