AUDIO-VESTIBULAR EVALUATION IN PATIENTS WITH CERVICOGENIC DIZZINESS

Abstract

Background: Cervicogenic dizziness has many potential mechanisms and is usually a diagnosis of exclusion. Otoacoustic emissions are used to assess cochlear function. Inner ear disorders commonly affect both cochlea and vestibular labyrinth. Posturography is used to evaluate the incorporation of sensory inputs; visual, vestibular and somatosensory which maintain posture and can be used in patients with cervicogenic dizziness. Objective: Analyze audiological, vestibular and postural findings in patients with spondylo-degenerative changes of the cervical spine with and without dizziness. Patients and Methods: This study was carried out on 70 patients with spondylo-degenerative changes of the cervical spine; 35 associated with dizziness and 35 without dizziness as a control group. Radiological assessment of the cervical spine was done and cervical degenerative index was used to assess severity. Basic audiological evaluation and videonystagmography were done to exclude peripheral and central vestibular lesions. Self-report of dizziness was measured using Dizziness Handicap Inventory. Otoacoustic emissions and posturography were assessed in all patients. Results: CDI total score was significantly higher in patients with dizziness. A positive correlation between CDI score and DHI scores was found. Lower OAES amplitudes were found in the patients with dizziness. SOT scores were lower in dizziness group compared to no-dizziness group. Conclusion: Severity of cervicogenic dizziness could be associated with severity of radiographic findings. Two possible mechanisms may have a role in cervicogenic dizziness include vascular compression mechanism, which was explained by otoacoustic emissions results. Another probable mechanism is neck proprioceptors damage resulting in postural problems in those patients.