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Functional ear symptoms referred to an otology clinic: incidence, co-morbidity, aetiological factors and a new experience-driven clinical model

Published online by Cambridge University Press:  08 July 2022

D W Scholfield Open the ORCID record for D W Scholfield [Opens in a new window] ,
D Chandrasekharan ,
A Bahra ,
M Williams  and
N Patel
D W Scholfield
Affiliation:
Department of ENT, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK
D Chandrasekharan
Affiliation:
Department of ENT, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK
A Bahra
Affiliation:
Department of Neurology, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK
M Williams
Affiliation:
Audiology Department, Anglia Ruskin University, Cambridge, London, UK
N Patel*
Affiliation:
Department of ENT, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK
*
Author for correspondence: Mr N Patel, ENT Department, Whipps Cross University Hospital, Barts Health NHS Trust, Whipps Cross Rd, London E11 1NR, UK E-mail: Nitesh.Patel@nhs.net
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Abstract

Objective

This study aimed to review the incidence and co-morbidity of functional ear symptoms in new referrals to an adult otology clinic and present a clinical model based on neuroscientific concepts.

Method

This was a retrospective review of 1000 consecutive new referrals to an adult otology clinic.

Results

Functional disorder was the primary diagnosis in 346 patients (34.6 per cent). Functional ear symptoms included tinnitus (69.7 per cent), imbalance (23.7 per cent), otalgia (22.8 per cent) and aural fullness (19.1 per cent), with more than one symptom occurring in 25.1 per cent of patients. Co-morbidities included sensorineural hearing loss (39 per cent), emotional stress (30 per cent) and chronic illness (22 per cent).

Conclusion

Functional disorders commonly present to the otology clinic, often in the presence of emotional stress or chronic illness. They occur because of adaptation of brain circuitry to experience, including adverse events, chronic illness and fear learning. This study presented an experience-driven clinical model based on these concepts. An understanding of these principles will significantly aid otolaryngologists who encounter patients with functional ear symptoms.

Keywords

TinnitusVertigoEaracheChronic PainMigraine Disorders
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 2 , February 2023 , pp. 143 - 150
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Mr N Patel takes responsibility for the integrity of the content of the paper

Presented at the European Association of Otology and Neuro-otology, 8 September 2021, London, UK and the British Academic Conference in Otolaryngology, 10–12th January 2021, Birmingham, UK

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