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What proportion of patients referred to an otolaryngology vertigo clinic have an otological cause for their symptoms?

Arya AK, Nunez DA

Department of Otolaryngology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.

BACKGROUND: Dizziness is a common and often complex complaint. Between nine and 13 per cent of patients seen in general practice are referred to a variety of specialist clinics. The diagnoses and outcomes of these referrals are seldom reported. AIMS: To determine the proportion of patients referred to an otology led vertigo clinic in whom an otological cause for vertigo could be identified. DESIGN OF STUDY: Prospective cohort study of consecutive new clinic attendees over one year. SETTING AND METHODS: Otology led vertigo clinic in an urban teaching hospital in England. Patients' details including age, sex, referring clinician, investigations, diagnoses, treatment and final outcome were recorded in an anonymised database. RESULTS: 91 new patients, 31 men and 60 women with a mean age of 52.6 years (range 16-81) were seen. General practitioners referred 87 per cent of the patients. Twenty-seven patients underwent further investigations including imaging, electronystagmography and other audiological tests. A labyrinthine disorder accounted for 50 per cent of the diagnoses. Ménière's disease or a variant was diagnosed in 20 patients (21 per cent). Fifty-six patients (61 per cent) reported resolution of or improvement in their symptoms. Thirty-one patients (34 per cent) were asymptomatic and free of abnormal findings on initial attendance and were discharged from hospital care. CONCLUSIONS: Forty-six patients (50.6 per cent, 95 per cent confidence interval, 40.4-60.6 per cent) had vertigo due to an otological disorder. The selection of an otolaryngology based vertigo clinic by the general practitioner for initial referral seems appropriate.

Published 6 February 2008 in J Laryngol Otol, 122(2): 145-9.
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