Analyze causes and results of VNG examinations in patients with vertigo and balance disorders in the private ENT practice

Abstract

Introduction: The aim of the study was to attempt to analyze the most common causes leading to dizziness, vertigo and balance disorders according to gender and age. Material and methods: Analysis of medical records and evaluation of VNG tests were performed on 608 patients of the private ENT practice “VERTIGO” in Opole between 2011 and 2017, including 404 women and 204 men. The patients’ age was in the range from 18 to 85 years, average age 49.88 years. The following parameters were taken into account in the analysis: the result of the subjective examination and the basic ENT and otoneurological examination, videonystagmographic examination, hearing assessment (tonal and impedance audiometry) and imaging tests (head MRI/CT and cervical spine x-ray), assessment of doppler ultrasound examination of vertebral arteries flow. Results: In examinations patients dizziness and vertigo were more common in women (66.45%) than men (33.55%), the most numerous was group of patients over 60 years, i.e. 30, 76%, systemic ver-tigo predominated (61.02%). Hypertension was the most common chronic disease in the entire popu-lation of patients with dizziness, vertigo and balance disorder and its frequency increases with age, which translates into an increase in the frequency of non-systemic and mixed dizziness reported by patients. The frequency of lipid metabolism disorders increases statistically significantly with age, while thyroid dysfunction as well as migraines and frequent headaches are significantly more com-mon in women reporting dizziness, vertigo and balance disorder than in men. In doppler ultrasound examination, while with age the frequency of bilateral disorders in vertebral artery flow increases significantly. The percentage of individual diagnoses in the examined patients was as follows: ves-tibular disorder (35.86%), benign paroxysmal positional vertigo (18.9%), mixed vertigo (16.12%), cervical vertigo (5.42%), Méniére's disease and its suspicion (5.1%), vertigo and dizziness of central origin (3.78%), vascular vertigo (2.8%), vestibular neuritis (2.3%), post-traumatic dizziness (1.32%) and the cerebellopontine angle tumors (0.16%). In the VNG study: in visual-oculomotor tests an in-crease in the percentage of pathology with age between 51 and 60 years old. Conclusions: The structure of diagnoses made in private practice differs from public health care. This results from the fact that the patient with acute symptoms first goes or is transported to the hospital emergency department. The second reason is the cost of diagnostics in the private sector which is not affordable to every patient.