Tyler Wilson, Dorina Kallogjeri, Belinda Sinks, Lauren English, Pawina Jiramongkolchai, Matthew Shew, Jacques Herzog, Craig Buchman, Jay Piccirillo, Nedim Durakovic
{"title":"前庭神经鞘瘤患者头晕的相关因素","authors":"Tyler Wilson, Dorina Kallogjeri, Belinda Sinks, Lauren English, Pawina Jiramongkolchai, Matthew Shew, Jacques Herzog, Craig Buchman, Jay Piccirillo, Nedim Durakovic","doi":"10.1001/jamaoto.2025.2849","DOIUrl":null,"url":null,"abstract":"<p><strong>Importance: </strong>Patients with vestibular schwannoma (VS) commonly present with neurological symptoms such as hearing loss, tinnitus, and dizziness. However, factors associated with dizziness at presentation are not well understood.</p><p><strong>Objective: </strong>To evaluate the baseline features of adults diagnosed with VS associated with subjective dizziness using a validated instrument.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study included adults with radiologically diagnosed VS who completed vestibular testing at Washington University (St Louis, Missouri) between June 2004 and January 2025. Baseline dizziness was measured using the Dizziness Handicap Inventory (DHI).</p><p><strong>Exposures: </strong>Anxiety associated with a VS diagnosis.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was severity of dizziness based on DHI score.</p><p><strong>Results: </strong>A total of 109 patients were included; the mean (SD) age was 61 (14) years, 57 (52%) were female, and 52 (48%) were male. The mean (SD) DHI score was 27 (24) points. Participants with a history of anxiety had a DHI score that was 13.7 points (95% CI, 4.2-23.2 points) higher than those with no such history. For every additional point in severity of anxiety measured using the Generalized Anxiety Disorder-7 (GAD-7) scale, DHI score increased 2.6 points (95% CI, 2.0-3.3 points). After controlling for covariates, for every 1-point increase in GAD-7, DHI score increased by a mean of 1.9 points (95% CI, 1.3-2.6 points). On average, patients with a history of anxiety had a DHI score 10.6 points (95% CI, 2.4-18.7 points) higher than those with no such history.</p><p><strong>Conclusions and relevance: </strong>This retrospective cohort study suggests a psychological association between anxiety and dizziness might exist among patients with VS that has not previously been explored. Further studies examining this association are needed in this patient population.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":5.6000,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Factors Associated With Dizziness Among Patients With Vestibular Schwannoma.\",\"authors\":\"Tyler Wilson, Dorina Kallogjeri, Belinda Sinks, Lauren English, Pawina Jiramongkolchai, Matthew Shew, Jacques Herzog, Craig Buchman, Jay Piccirillo, Nedim Durakovic\",\"doi\":\"10.1001/jamaoto.2025.2849\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Importance: </strong>Patients with vestibular schwannoma (VS) commonly present with neurological symptoms such as hearing loss, tinnitus, and dizziness. However, factors associated with dizziness at presentation are not well understood.</p><p><strong>Objective: </strong>To evaluate the baseline features of adults diagnosed with VS associated with subjective dizziness using a validated instrument.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study included adults with radiologically diagnosed VS who completed vestibular testing at Washington University (St Louis, Missouri) between June 2004 and January 2025. Baseline dizziness was measured using the Dizziness Handicap Inventory (DHI).</p><p><strong>Exposures: </strong>Anxiety associated with a VS diagnosis.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was severity of dizziness based on DHI score.</p><p><strong>Results: </strong>A total of 109 patients were included; the mean (SD) age was 61 (14) years, 57 (52%) were female, and 52 (48%) were male. The mean (SD) DHI score was 27 (24) points. Participants with a history of anxiety had a DHI score that was 13.7 points (95% CI, 4.2-23.2 points) higher than those with no such history. For every additional point in severity of anxiety measured using the Generalized Anxiety Disorder-7 (GAD-7) scale, DHI score increased 2.6 points (95% CI, 2.0-3.3 points). After controlling for covariates, for every 1-point increase in GAD-7, DHI score increased by a mean of 1.9 points (95% CI, 1.3-2.6 points). On average, patients with a history of anxiety had a DHI score 10.6 points (95% CI, 2.4-18.7 points) higher than those with no such history.</p><p><strong>Conclusions and relevance: </strong>This retrospective cohort study suggests a psychological association between anxiety and dizziness might exist among patients with VS that has not previously been explored. 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Factors Associated With Dizziness Among Patients With Vestibular Schwannoma.
Importance: Patients with vestibular schwannoma (VS) commonly present with neurological symptoms such as hearing loss, tinnitus, and dizziness. However, factors associated with dizziness at presentation are not well understood.
Objective: To evaluate the baseline features of adults diagnosed with VS associated with subjective dizziness using a validated instrument.
Design, setting, and participants: This retrospective cohort study included adults with radiologically diagnosed VS who completed vestibular testing at Washington University (St Louis, Missouri) between June 2004 and January 2025. Baseline dizziness was measured using the Dizziness Handicap Inventory (DHI).
Exposures: Anxiety associated with a VS diagnosis.
Main outcomes and measures: The primary outcome was severity of dizziness based on DHI score.
Results: A total of 109 patients were included; the mean (SD) age was 61 (14) years, 57 (52%) were female, and 52 (48%) were male. The mean (SD) DHI score was 27 (24) points. Participants with a history of anxiety had a DHI score that was 13.7 points (95% CI, 4.2-23.2 points) higher than those with no such history. For every additional point in severity of anxiety measured using the Generalized Anxiety Disorder-7 (GAD-7) scale, DHI score increased 2.6 points (95% CI, 2.0-3.3 points). After controlling for covariates, for every 1-point increase in GAD-7, DHI score increased by a mean of 1.9 points (95% CI, 1.3-2.6 points). On average, patients with a history of anxiety had a DHI score 10.6 points (95% CI, 2.4-18.7 points) higher than those with no such history.
Conclusions and relevance: This retrospective cohort study suggests a psychological association between anxiety and dizziness might exist among patients with VS that has not previously been explored. Further studies examining this association are needed in this patient population.
期刊介绍:
JAMA Otolaryngology–Head & Neck Surgery is a globally recognized and peer-reviewed medical journal dedicated to providing up-to-date information on diseases affecting the head and neck. It originated in 1925 as Archives of Otolaryngology and currently serves as the official publication for the American Head and Neck Society. As part of the prestigious JAMA Network, a collection of reputable general medical and specialty publications, it ensures the highest standards of research and expertise. Physicians and scientists worldwide rely on JAMA Otolaryngology–Head & Neck Surgery for invaluable insights in this specialized field.