The Correlation Between Fear Avoidance Beliefs and Physical Activity in Unilateral Vestibulopathies.

Background And Purpose: In individuals with unilateral vestibulopathy (UVP), physical activity (PA) is recommended to stimulate central vestibular compensation. However, the presence of fear avoidance beliefs might negatively influence PA. The objectives of this study were to investigate the relationship between fear avoidance beliefs and PA and to compare PA levels between individuals with UVP in an acute/subacute vs chronic phase.

The effectiveness of intratympanic injections with methylPREDnisolon versus placebo in the treatment of vertigo attacks in MENière's disease (PREDMEN trial): a study protocol for a phase-3 multicentre, double-blinded, randomised, placebo-controlled trial.

Introduction: Intratympanic corticosteroids are commonly used in the treatment of Menière's disease (MD). However, few and small randomised controlled trials (RCT) on the effectiveness of intratympanic corticosteroids have been performed. A recent Cochrane review suggested that a well-conducted placebo-controlled RCT with a large study population is required to evaluate the effectiveness of the use of intratympanic corticosteroids in MD.

Assessing risk of stroke after idiopathic sudden sensorineural hearing loss using data from general practice.

The cause of sudden sensorineural hearing loss (SSNHL) remains unknown in a significant number of cases, but vascular involvement in its pathophysiology has been proposed. Our study aimed to assess the incidence of stroke following idiopathic SSNHL (iSSNHL) and to evaluate associated cardiovascular risk factors and comorbidities. We extracted electronic medical record data from iSSNHL patients aged ≥ 50 years retrospectively from 84 general practices.

Prospective diagnostic accuracy study of history taking and physical examination for adults with vertigo in general practice: study protocol.

Introduction: Vertigo is a prevalent and burdensome symptom. More than 80% of patients with vertigo are primarily treated by their general practitioner (GP) and are never referred to a medical specialist. Despite this therapeutic responsibility, the GP's diagnostic toolkit has serious limitations.

Cerebral Small Vessel Disease in Elderly Patients With Menière's Disease.

Background: Menière's disease (MD) is an inner ear disease characterized by vertigo attacks, progressive hearing loss, tinnitus, and the sensation of aural fullness. Although the exact pathophysiology of MD is unknown, endolymphatic hydrops is considered to be its histopathological hallmark. It has been suggested that endolymphatic hydrops results from lowered perfusion pressure due to cardiovascular comorbidity.

Idiopathic Labyrinthitis: Symptoms, Clinical Characteristics, and Prognosis.

Background: Labyrinthitis is an inner ear disorder of unknown incidence, characterized by sudden hearing loss and concurrent vertigo. Cohort studies of patients diagnosed with labyrinthitis are nonexistent. This study aims to describe the clinical characteristics and prognosis of patients diagnosed with idiopathic labyrinthitis.

Study protocol for a nationwide implementation of internet-based vestibular rehabilitation for patients with chronic vestibular symptoms (I-RECOVER).

Background: Vestibular rehabilitation is a safe and effective exercise-based treatment for patients with chronic vestibular symptoms. However, it is underused in general practice. Internet-based vestibular rehabilitation (Vertigo Training), which has proven to be effective as well, was developed to increase uptake.

Cardiovascular Risk Factors, Cerebral Small Vessel Disease, and Subsequent Risk of Stroke in Patients with Idiopathic Sudden Sensorineural Hearing Loss: Systematic Review and Meta-Analyses of the Current Literature.

Vascular involvement in the pathophysiology of idiopathic sudden sensorineural hearing loss (iSSNHL) has been previously proposed. The objective of this study was to perform a systematic review of the current literature and conduct meta-analyses to evaluate associations between cardiovascular risk factors, cerebral small vessel disease, and subsequent stroke after presentation with iSSNHL. Three systematic literature reviews and meta-analyses were conducted using PubMed, Embase, and CINAHL.

The Diagnostic Value of Multifrequency Tympanometry in Patients with Ménière's Disease: A Prospective Analysis.

Introduction: Diagnosing Ménière's disease (MD) by its characteristics such as episodes of vertigo, fluctuating hearing loss, and tinnitus with aural fullness remains challenging. Available tests evaluating the presence of endolymphatic hydrops (EH) are often expensive or time assuming. An in-office quick and simple non-invasive diagnostic test is multifrequency tympanometry (MFT).

The clinical significance of the human vomeronasal organ.

Objective: To find out whether the vomeronasal organ (VNO) can be identified in the nose as a mucosal pit in the anterior nasal septum, to elucidate its function in man and to determine whether it is important to preserve the VNO during septal surgery.

Methods: Literature review.

Results And Conclusion: The VNO is histologically present in almost all humans, but a macroscopically visible septal pit does not necessarily correspond with the actual VNO.

Cerebral Small Vessel Disease in Elderly Patients with Sudden Sensorineural Hearing Loss.

Background: The cause of sudden sensorineural hearing loss (SSNHL) is uncertain in a significant number of patients. A vascular etiology has been proposed because SSNHL increases the risk of developing a stroke. Cardiovascular risk factors can cause cerebral small vessel disease (CSVD).

Bilateral Vestibular Hypofunction in a Tertiary Dizziness Center: Occurrence and Etiology.

Background: The primary goal of this study was to determine the occurrence of bilateral vestibular hypofunction in a specialized dizziness clinic and to assess the etiology in patients diagnosed with bilateral vestibular hypofunction. Secondary goal was to find out if the diagnosis was already made before the patient was seen at our clinic.

Methods: A retrospective cohort study, including patients who visited our specialized dizziness center between January 1, 2008, and December 31, 2018, fulfilling the criteria for bilateral vestibular hypofunction according to the Classification Committee of the Bárány Society (2017).

[Dizziness].

Dizziness is a frequently occurring problem with a negative influence on quality of life. In this article, the most common causes of dizziness are discussed on the basis of practical questions from clinical practice. The importance of a structured anamnesis is reviewed.

Cerebral Small Vessel Disease in Elderly Patients With Vestibular Neuritis.

Background: Acute audiovestibular loss is a neurotologic emergency of which the etiology is frequently unknown. In vestibular neuritis a viral genesis is expected, although there is insufficient evidence to support viruses as the only possible etiological factor. In sudden deafness, a vascular etiology has been proposed in elderly patients, since cardiovascular risk factors are more frequently present and a higher risk of developing a stroke was seen compared to the general population.

Measurement Properties of the Dizziness Handicap Inventory: A Systematic Review.

Objective: To critically appraise and summarize the quality of the measurement properties of the Dizziness Handicap Inventory's (DHI) in adult patients with complaints of dizziness.

Databases Reviewed: Pubmed, Embase, and CINAHL.

Methods: The selected literature databases were systematically searched to identify studies investigating one or more measurement properties of the DHI.

A non-invasive, automated diagnosis of Menière's disease using radiomics and machine learning on conventional magnetic resonance imaging: A multicentric, case-controlled feasibility study.

Purpose: This study investigated the feasibility of a new image analysis technique (radiomics) on conventional MRI for the computer-aided diagnosis of Menière's disease.

Materials And Methods: A retrospective, multicentric diagnostic case-control study was performed. This study included 120 patients with unilateral or bilateral Menière's disease and 140 controls from four centers in the Netherlands and Belgium.

Interventions for Menière's disease: an umbrella systematic review.

Objectives: To systematically review the efficacy of interventions for Menière's disease (MD) to report clinical implications of the results and to identify areas for future valuable research.

Methods: In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Abstracts (PRISMA-A) guideline, a systematic online database search was conducted in which MEDLINE (PubMed), Embase (Ovid) and CENTRAL (Cochrane Library) were searched until May 2021 in order to search for the efficacy of treatment was analysed in a systematic review. Systematic reviews (SRs) on treatments for MD were screened for eligible interventions.

Treatment Results of Geotropic and Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo in a Tertiary Dizziness Clinic.

To determine the effectiveness of our treatment protocol for geotropic and apogeotropic horizontal canal benign paroxysmal positional vertigo (h-BPPV). We retrospectively evaluated patients with newly diagnosed geotropic and apogeotropic h-BPPV who visited our clinic between July 2017 and December 2019. Patients were treated according to our treatment protocol, which was implemented in 2017.

Dizziness and Driving From a Patient Perspective.

People with dizziness may experience driving-related limitations. Few data are available about the impact of dizziness on driving. The aim of this study is to investigate the impact of dizziness on driving, factors related to impairment (age, gender, and type of diagnosis), and the potential consequences for patients' ability to work.

Betahistine in Ménière's Disease or Syndrome: A Systematic Review.

Background: Ménière's disease is characterized by recurrent episodes of vertigo, hearing loss, and tinnitus, often with a feeling of fullness in the ear. Although betahistine is thought to be specifically effective for Ménière's disease, no evidence for a benefit from the use of betahistine exists, despite its widespread use. Reassessment of the effect of betahistine for Ménière's disease is now warranted.

Two Symptoms Strongly Suggest Benign Paroxysmal Positional Vertigo in a Dizzy Patient.

This prospective cohort study determined which questions in patient history are most likely to identify symptoms that are independently associated with a diagnosis of benign paroxysmal positional dizziness (BPPV) in patients presenting with dizziness, and to evaluate whether the patient's age and type of BPPV are of influence. We included adult patients with dizziness referred to our dizziness center, Apeldoorn, the Netherlands, from December 2018 to November 2019. All patients completed a questionnaire, underwent vestibular testing and received a diagnosis.

Deep learning for the fully automated segmentation of the inner ear on MRI.

Segmentation of anatomical structures is valuable in a variety of tasks, including 3D visualization, surgical planning, and quantitative image analysis. Manual segmentation is time-consuming and deals with intra and inter-observer variability. To develop a deep-learning approach for the fully automated segmentation of the inner ear in MRI, a 3D U-net was trained on 944 MRI scans with manually segmented inner ears as reference standard.

The "hype" of hydrops in classifying vestibular disorders: a narrative review.

Background: Classifying and diagnosing peripheral vestibular disorders based on their symptoms is challenging due to possible symptom overlap or atypical clinical presentation. To improve the diagnostic trajectory, gadolinium-based contrast-enhanced magnetic resonance imaging of the inner ear is nowadays frequently used for the in vivo confirmation of endolymphatic hydrops in humans. However, hydrops is visualized in both healthy subjects and patients with vestibular disorders, which might make the clinical value of hydrops detection on MRI questionable.