Otology & Neurotology Open最新文献

{"title":"How to Disclose Internal Carotid Artery Dehiscence in Patients With Eustachian Tube Dysfunction: Cone Beam Computed Tomography or High-resolution Computed Tomography?","authors":"N. Holm, Balázs Molnár, Therese Ovesen","doi":"10.1097/ono.0000000000000057","DOIUrl":"https://doi.org/10.1097/ono.0000000000000057","url":null,"abstract":"\u0000 \u0000 To compare the prevalence of internal carotid artery dehiscence (ICAD) on high-resolution computed tomography (HRCT) and cone beam computed tomography (CBCT) in patients with Eustachian tube dysfunction (ETD).\u0000 \u0000 \u0000 \u0000 A prospective, cohort study.\u0000 \u0000 \u0000 \u0000 The outpatient clinic at the Department of Otorhinolaryngology, Head and Neck Surgery at Gødstrup Hospital, Denmark (tertiary referral center).\u0000 \u0000 \u0000 \u0000 Patients >18 years of age diagnosed with long-standing ETD undergoing HRCT and/or CBCT prior to balloon Eustachian tuboplasty.\u0000 \u0000 \u0000 \u0000 Patients had either initially HRCT and later CBCT performed (HRCT + CBCT group) or solely CBCT (CBCT group).\u0000 \u0000 \u0000 \u0000 Prevalence of ICAD assessed with HRCT and CBCT.\u0000 \u0000 \u0000 \u0000 A total of 23 patients were included in the HRCT + CBCT group and 36 patients in the CBCT group. In the HRCT + CBCT group, ICAD was found in 13 temporal bones (28.3%) with HRCT and 7 temporal bones (15.2%) with CBCT (P = 0.0003). No new cases of ICAD were found with CBCT. In the CBCT group, ICAD was found in 6 temporal bones (8.3%). In both HRCT and CBCT, patients suffered from ETD in 61.5% of the ears where ICAD was found.\u0000 \u0000 \u0000 \u0000 CBCT has a higher specificity than HRCT in diagnosing ICAD in patients with ETD while at the same time using less radiation.\u0000","PeriodicalId":124165,"journal":{"name":"Otology & Neurotology Open","volume":" 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141676431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automatic Segmentation of Heschl Gyrus and Planum Temporale by MRICloud","authors":"Carlos Perez-Heydrich, Dominic Padova, Kwame S. Kutten, C. Ceritoglu, Andreia Faria, J. Ratnanather, Yuri Agrawal","doi":"10.1097/ono.0000000000000056","DOIUrl":"https://doi.org/10.1097/ono.0000000000000056","url":null,"abstract":"\u0000 \u0000 This study used a cloud-based program, MRICloud, which parcellates T1 MRI brain scans using a probabilistic classification based on manually labeled multi-atlas, to create a tool to segment Heschl gyrus (HG) and the planum temporale (PT).\u0000 \u0000 \u0000 \u0000 MRICloud is an online platform that can automatically segment structural MRIs into 287 labeled brain regions. A 31-brain multi-atlas was manually resegmented to include tags for the HG and PT. This modified atlas set with additional manually labeled regions of interest acted as a new multi-atlas set and was uploaded to MRICloud. This new method of automated segmentation of HG and PT was then compared to manual segmentation of HG and PT in MRIs of 10 healthy adults using Dice similarity coefficient (DSC), Hausdorff distance (HD), and intraclass correlation coefficient (ICC).\u0000 \u0000 \u0000 \u0000 This multi-atlas set was uploaded to MRICloud for public use. When compared to reference manual segmentations of the HG and PT, there was an average DSC for HG and PT of 0.62 ± 0.07, HD of 8.10 ± 3.47 mm, and an ICC for these regions of 0.83 (0.68–0.91), consistent with an appropriate automatic segmentation accuracy.\u0000 \u0000 \u0000 \u0000 This multi-atlas can alleviate the manual segmentation effort and the difficulty in choosing an HG and PT anatomical definition. This protocol is limited by the morphology of the MRI scans needed to make the MRICloud atlas set. Future work will apply this multi-atlas to observe MRI changes in hearing-associated disorders.\u0000","PeriodicalId":124165,"journal":{"name":"Otology & Neurotology Open","volume":" 39","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141673372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of Publicly Available Digital Endoscopes in Otolaryngology: A Pilot Study","authors":"Michael P. McWilliams, Kevin Quinn, Lawrance Lee, Nauman F. Manzoor, Daniel H. Coelho","doi":"10.1097/ono.0000000000000055","DOIUrl":"https://doi.org/10.1097/ono.0000000000000055","url":null,"abstract":"\u0000 \u0000 To compare the utility, accuracy, and confidence of an inexpensive, commercially available endoscope (not specifically designed for medical use) with traditional methods in the diagnosis of otologic conditions.\u0000 \u0000 \u0000 \u0000 This is a prospective study.\u0000 \u0000 \u0000 \u0000 Following institutional review board approval, patients were recruited from a tertiary university-based otology/neurotology clinic. Complete history and physical were obtained by the resident, including both traditional handheld otoscopy and image captured from a commercially available digital endoscopic device (AnyKit Digital Otoscope with 4.5-inch screen). The patient was then presented to the attending without the endoscopic images and a putative diagnosis was made. The endoscopic images were then shown and the putative diagnosis was affirmed or rejected. The attending then examined the patient and determined the final diagnosis using the microscope. Data collected included resident year, resident and attending diagnosis before and after digital-otoscopic images, confidence in diagnosis (1–5 scale), and agreement between the initial putative diagnosis and the final diagnosis. Noninferiority testing was calculated using inter-rater agreement between digital-otoscopic and final diagnoses. Differences between resident and attending confidence were analyzed. A power analysis was performed and the sample size was calculated a priori.\u0000 \u0000 \u0000 \u0000 A total of 62 participants (114 ears examinations) were enrolled. Cohen’s kappa coefficient showed very high agreement between both resident and attending digital-otoscopic and final diagnosis (kappa = 0.868 and 0.882, respectively) suggesting noninferiority between the digital otoscope and the final diagnosis. There was no significant difference between attending confidence in diagnosis following resident presentation versus attending confidence in diagnosis after reviewing images (4.65 vs 4.61, P = 0.701). Average resident confidence in digital-otoscopic diagnosis remained above 4.2 throughout the study.\u0000 \u0000 \u0000 \u0000 Inexpensive and readily available digital endoscopes are not inferior to the traditional methods of resident-attending consultation and may provide some substantial benefits. Such devices have the potential to enhance both patient care and resident education when faculty are not immediately available (ie, inpatient and emergency room consults) and improve patient-initiated communications.\u0000","PeriodicalId":124165,"journal":{"name":"Otology & Neurotology Open","volume":"121 34","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141126341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Video Head Impulse Testing in Patients With Acute Vestibular Dysfunction","authors":"Fumihiro Mochizuki, Yusuke Ito, Y. Sasano, Erin Williams, Michael E. Hoffer, Manabu Komori, Izumi Koizuka","doi":"10.1097/ono.0000000000000052","DOIUrl":"https://doi.org/10.1097/ono.0000000000000052","url":null,"abstract":"\u0000 \u0000 The video head impulse test (v-HIT) can evaluate the function of all semicircular canals (SCCs) in a short period. In this work, we sought to compare v-HIT results among 2 commercially available devices, the ICS impulse (Otometrics, Denmark) (ICS) and Eye See Cam (Interacoustics, Denmark) (ESC), among individuals with unilateral vestibular disorders.\u0000 \u0000 \u0000 \u0000 Retrospective study (n = 15).\u0000 \u0000 \u0000 \u0000 St. Marianna University School of Medicine Hospital.\u0000 \u0000 \u0000 \u0000 Fifteen patients with acute unilateral vestibular disorders.\u0000 \u0000 \u0000 \u0000 Two v-HIT devices were conducted across patients to compare the results of the 2 models.\u0000 \u0000 \u0000 \u0000 Gain values and pathological saccades for each SCC were compared across the 2 models. Monothermal caloric testing was performed to compare alongside v-HIT gain values.\u0000 \u0000 \u0000 \u0000 There was no difference between the 2 models for the evaluation of the horizontal SCCs. There was a significant negative correlation (ESC: r = −0.52, ICS: r = −0.53) between caloric testing and the gain values of the 2 models. In the vertical SCCs, the gain values of ESC were significantly higher than the gain values of ICS. Detection of catch-up saccades in vertical SCCs was similar across the 2 models.\u0000 \u0000 \u0000 \u0000 For the horizontal SCCs, there was no difference in test results between the 2 models. However, in the vertical SCCs, gain values were variable across the 2 devices. Larger scale studies are needed to develop normative ranges for the vertical canals.\u0000","PeriodicalId":124165,"journal":{"name":"Otology & Neurotology Open","volume":"106 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140709102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Incidence of Vestibular Disorders in Patients With SARS-CoV-2","authors":"Lawrance Lee, Evan French, Daniel H. Coelho, Nauman F. Manzoor","doi":"10.1097/ono.0000000000000051","DOIUrl":"https://doi.org/10.1097/ono.0000000000000051","url":null,"abstract":"\u0000 \u0000 Determine the incidence of vestibular disorders in patients with SARS-CoV-2 compared to the control population.\u0000 \u0000 \u0000 \u0000 Retrospective.\u0000 \u0000 \u0000 \u0000 Clinical data in the National COVID Cohort Collaborative database (N3C).\u0000 \u0000 \u0000 \u0000 Deidentified patient data from the National COVID Cohort Collaborative database (N3C) were queried based on variant peak prevalence (untyped, alpha, delta, omicron 21K, and omicron 23A) from covariants.org to retrospectively analyze the incidence of vestibular disorders in patients with SARS-CoV-2 compared to control population, consisting of patients without documented evidence of COVID infection during the same period.\u0000 \u0000 \u0000 \u0000 Patients testing positive for COVID-19 were significantly more likely to have a vestibular disorder compared to the control population. Compared to control patients, the odds ratio of vestibular disorders was significantly elevated in patients with untyped (odds ratio [OR], 2.39; confidence intervals [CI], 2.29–2.50; P < 0.001), alpha (OR, 3.63; CI, 3.48–3.78; P < 0.001), delta (OR, 3.03; CI, 2.94–3.12; P < 0.001), omicron 21K variant (OR, 2.97; CI, 2.90–3.04; P < 0.001), and omicron 23A variant (OR, 8.80; CI, 8.35–9.27; P < 0.001).\u0000 \u0000 \u0000 \u0000 The incidence of vestibular disorders differed between COVID-19 variants and was significantly elevated in COVID-19-positive patients compared to the control population. These findings have implications for patient counseling and further research is needed to discern the long-term effects of these findings.\u0000","PeriodicalId":124165,"journal":{"name":"Otology &amp; Neurotology Open","volume":"31 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140753085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Early Cochlear Implant Performance: Can Cognitive Testing Help?","authors":"Natalie Schauwecker, Terrin N. Tamati, A. Moberly","doi":"10.1097/ono.0000000000000050","DOIUrl":"https://doi.org/10.1097/ono.0000000000000050","url":null,"abstract":"\u0000 \u0000 There is significant variability in speech recognition outcomes in adults who receive cochlear implants (CIs). Little is known regarding cognitive influences on very early CI performance, during which significant neural plasticity occurs.\u0000 \u0000 \u0000 \u0000 Prospective study of 15 postlingually deafened adult CI candidates tested preoperatively with a battery of cognitive assessments. The mini-mental state exam (MMSE), forward digit span, Stroop measure of inhibition-concentration, and test of word reading efficiency were utilized to assess cognition. consonant-nucleus-consonant words, AZBio sentences in quiet, and AZBio sentences in noise (+10 dB SNR) were utilized to assess speech recognition at 1- and 3-months of CI use.\u0000 \u0000 \u0000 \u0000 Performance in all speech measures at 1-month was moderately correlated with preoperative MMSE, but these correlations were not strongly correlated after correcting for multiple comparisons. There were large correlations of forward digit span with 1-month AzBio quiet (P ≤ 0.001, rho = 0.762) and AzBio noise (P ≤ 0.001, rho = 0.860), both of which were strong after correction. At 3 months, forward digit span was strongly predictive of AzBio noise (P ≤ 0.001, rho = 0.786), which was strongly correlated after correction. Changes in speech recognition scores were not correlated with preoperative cognitive test scores.\u0000 \u0000 \u0000 \u0000 Working memory capacity significantly predicted early CI sentence recognition performance in our small cohort, while other cognitive functions assessed did not. These results differ from prior studies predicting longer-term outcomes. Findings and further studies may lead to better preoperative counseling and help identify patients who require closer evaluation to ensure optimal CI performance.\u0000","PeriodicalId":124165,"journal":{"name":"Otology &amp; Neurotology Open","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140269446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Portable, Very Low-field (0.064T) MRI to Image Cochlear Implants: Metallic Image Artifact in Comparison to Traditional, Stationary 3T MRI","authors":"C. C. Munhall, Donna R. Roberts, Robert F. Labadie","doi":"10.1097/ono.0000000000000049","DOIUrl":"https://doi.org/10.1097/ono.0000000000000049","url":null,"abstract":"\u0000 \u0000 To assess image artifact when imaging a cochlear implant (CI) with a conventional 3T MRI machine compared with a very low-field (0.064T) MRI.\u0000 \u0000 \u0000 \u0000 None.\u0000 \u0000 \u0000 \u0000 Diagnostic study.\u0000 \u0000 \u0000 \u0000 Image artifact size associated with the CI affixed to an MRI phantom at very low-field 0.064T MRI versus 3T MRI.\u0000 \u0000 \u0000 \u0000 The longest diameter of the image artifact was 125 mm for the 3T MRI and 86 mm for the 0.064T MRI, representing 45% longer image artifact generated in the 3T MRI. The actual volume of the imaging phantom was 1371 cm3. The volume of the image artifact was measured as 379 cm3 in the 3T MRI, representing a loss of 27.6% of the actual volume of the imaging phantom. The volume of image artifact was measured as 170 cm3 in the 0.064T MRI, representing a loss of 12.4% of the phantom volume.\u0000 \u0000 \u0000 \u0000 3T MRI had better image quality. This result was not surprising given that larger magnetic field strength is known to provide higher resolution. There was 15% less image artifact generated in the very low-field MRI machine compared with a conventional 3T device. And there was also subjectively increased distortion of the imaging phantom at 3T MRI compared with the 0.064T MRI. With minimized safety concerns and a much lower cost than conventional 3T machines, very low-field scanners may find expanded clinical uses. This preclinical study explores the potential utility of very low-field MRI in scanning CI recipients.\u0000","PeriodicalId":124165,"journal":{"name":"Otology &amp; Neurotology Open","volume":"137 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140272846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of Reduced Diameter of the Cochlear Nerve in Long-term Deaf Patients Quantified With Semiautomatic Measurement of Nerve Cross-sectional Area Using 3T MRI Data","authors":"Katrin Reimann, Uwe Klose, Ulrike Ehrenpfordt, Kruthika Thangavelu, Maximilian Schulze","doi":"10.1097/ono.0000000000000047","DOIUrl":"https://doi.org/10.1097/ono.0000000000000047","url":null,"abstract":"\u0000 \u0000 High-resolution parallel transmit T2 sampling perfection with application optimized contrast using different flip angle evolution sequence with improved edge discrimination and semiautomatic determination of nerve cross-sectional area (CSA) can be used to evaluate nerve degeneration in the inner auditory canal (IAC) in long-term deaf patients.\u0000 \u0000 \u0000 \u0000 In patients with hearing loss, temporal bone MRI is routinely acquired to evaluate the morphology of the nerves within the IAC. Earlier studies have shown that the diameter of the cochlear nerve can be used as prognostic marker for the auditory performance after cochlear implantation in postlingually deaf patients.\u0000 \u0000 \u0000 \u0000 Eighty-two consecutive MRI scans were analyzed using a semiautomatic tool to measure CSA of cranial nerves in the IAC. Results were correlated with patient history and audiology testing as well as with age and gender.\u0000 \u0000 \u0000 \u0000 There was a significant reduced CSA of the cochlear nerve in ears with moderate-to-profound hearing loss and deafness compared with ears with normal hearing, but no significant difference in ears with mild-to-moderate hearing loss compared with normal hearing. In detail, normal hearing ears had a CSA of 1.23 ± 0.11 mm2, whereas ears with pantonal hearing loss of more than 40 dB had 1.02 ± 0.05 mm2 (P = 0.026). Maximal CSA of the facial nerve was not different among all groups (average, 1.04 mm2 ± 0.03; linear regression, P = 0.001) and stable with age. However, vestibular nerve CSA decreased significantly with age (average, 1.78 ± 0.05 mm2; linear regression, P = 0.128).\u0000 \u0000 \u0000 \u0000 In long-term deaf patients, smaller the diameter of cochlear nerve is the more severe the hearing loss is. The new semiautomatic tool can primarily be used to assess nerve diameter and possibly determine ears with nerve degeneration.\u0000","PeriodicalId":124165,"journal":{"name":"Otology &amp; Neurotology Open","volume":"72 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139596898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of the COVID-19 Pandemic on Real-world Functioning in Adult Cochlear-implant Users","authors":"Tyler J. Young, Kara J. Schneider, Aaron Moberly, Terrin N. Tamati","doi":"10.1097/ono.0000000000000048","DOIUrl":"https://doi.org/10.1097/ono.0000000000000048","url":null,"abstract":"\u0000 \u0000 As a result of COVID-19 lockdowns and the associated effects on the auditory-social environments of cochlear-implant (CI) users, we expected that adult CI users would report a decrease in real-world communication abilities, a decrease in social isolation, and a decrease in quality of life (QOL) from pre- to post-pandemic.\u0000 \u0000 \u0000 \u0000 The COVID-19 pandemic brought many changes to the environments in which adults with CIs interact and communicate. However, the impact of these changes on CI users’ real-world functioning is not well understood. This study investigated the impact of the COVID-19 pandemic on real-world communication abilities, social isolation, and CI-related QOL in adult CI users.\u0000 \u0000 \u0000 \u0000 Fourteen adult CI users completed self-report questionnaires assessing communication abilities, social isolation, and CI-related QOL at time points before and after the onset of the COVID-19 pandemic. Responses at the 2 time points were compared to evaluate changes in CI users’ real-world functioning.\u0000 \u0000 \u0000 \u0000 Adult CI users showed a significant decrease in self-reported communication ability and a nonsignificant decline in CI-related QOL from before to during COVID-19. However, a nonsignificant trend of a decline in social isolation was also observed in adult CI users.\u0000 \u0000 \u0000 \u0000 Findings showed a decrease in self-reported communication abilities and, to a lesser extent, CI-related QOL, suggesting that changes to the auditory-social environment brought on by the COVID-19 pandemic may have negatively impacted communication abilities in real-world, challenging environments. Yet, the potential decrease in social isolation suggests that these changes may have had an overall positive effect on social interaction, potentially with close family and friends in well-controlled environments. Assessing changes in real-world functioning in the same CI users from both before and during the COVID-19 pandemic provided a unique glimpse into how changes in the auditory-social environment may impact outcomes in adult CI users.\u0000","PeriodicalId":124165,"journal":{"name":"Otology &amp; Neurotology Open","volume":"14 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139597748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed Diagnoses in Patients With Dizziness in the US Commonwealth of Virginia and the Tidewater Region","authors":"Kendra N Walker, Kevin M. Guy, Peter G. Volsky","doi":"10.1097/ono.0000000000000046","DOIUrl":"https://doi.org/10.1097/ono.0000000000000046","url":null,"abstract":"\u0000 \u0000 In a region of approximately 1.7 million people (Tidewater, coastal Virginia), identify secondary diagnoses in persons with dizziness.\u0000 \u0000 \u0000 \u0000 This cross-sectional study utilizing TriNetX included individuals in the region of interest diagnosed with dizziness between 2010 and 2020. Subsequent diagnoses of vestibular disease or medical conditions possibly associated with dizziness in the same subjects were catalogued.\u0000 \u0000 \u0000 \u0000 During the study period, 31,670 subjects were identified with diagnoses of dizziness as a symptom; 18,390 subjects were subsequently given a dizziness-related nonvestibular diagnosis, and 930 were given a subsequent vestibular disease diagnosis. The proportion of subjects diagnosed with vestibular disease (3%) after the dizziness diagnosis is far below expected norms (25%–34%) in the general population. There were greater proportions of delayed diagnoses of labyrinth dysfunction (odds ratio [OR], 4.8; P < 0.0001), superior semicircular canal dehiscence (OR, 3.1; P = 0.0023), otolith disease (OR, 3.1; P = 0.0023), among others, and a decreased proportion of delayed diagnosis of benign paroxysmal positional vertigo (OR, 0.56; P < 0.0001).\u0000 \u0000 \u0000 \u0000 The discrepancy between expected and observed prevalence in our region indicates that vestibular disease is likely underdiagnosed.\u0000","PeriodicalId":124165,"journal":{"name":"Otology &amp; Neurotology Open","volume":"82 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138989019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}