Examining Sociodemographic Differences in the Management of Vestibular Neuritis and Labyrinthitis by Ear, Nose, and Throat Providers and Vestibular Rehabilitation Outcomes.

Abstract

Purpose: This study aims to determine the most common management strategies for vestibular neuritis and labyrinthitis (VNL) by ear, nose, and throat (ENT) providers and identify sociodemographic variations in vestibular rehabilitation therapy (VRT) referral rates and VNL patient performance on baseline VRT assessments.

Method: A retrospective study of all adult patients with a single diagnosis of VNL who visited a multiprovider tertiary ENT clinic (n = 168) was conducted. Demographic information, treatment recommendations, and baseline vestibular rehabilitation performance information were extracted from ENT clinical notes and initial VRT notes. Chi-square and Fisher's exact tests were performed to evaluate sociodemographic differences, and p ≤ .003 was considered statistically significant.

Results: VRT was the most popular treatment recommendation made by ENT providers, and VRT referral rates did not vary according to sociodemographic factors. 68.8% of referred patients initiated VRT. The number of patients with abnormal baseline VRT assessments did not differ by sex or race. More public insurance holders had abnormal Dynamic Gait Index assessment scores (p = .001) and gait speeds than did private insurance holders (p < .001).

Conclusions: VRT was the most frequent clinical management strategy recommended to VNL patients by ENT providers, and referral rates did not vary by sex, race, or insurance status. Most VRT patients had vestibular dysfunction on baseline assessments, suggesting appropriate referral of VRT by ENT. VNL patients' baseline vestibular function did not vary by sex or race but did vary by insurance status. Further work is needed to investigate study generalizability and elucidate the impact of insurance type on fall risk.

Supplemental material: https://doi.org/10.23641/asha.30053206.