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Primary assessment of the vertiginous patient at a pre-ENT balance clinic

Published online by Cambridge University Press:  01 May 2007

A C Leong ,
F Barker  and
N R Bleach
A C Leong*
Affiliation:
Department of Otolaryngology, Wexham Park Hospital, Slough, UK
F Barker
Affiliation:
Department of Audiology, King Edward VII Hospital, Windsor, UK
N R Bleach
Affiliation:
Department of Otolaryngology, Wexham Park Hospital, Slough, UK
*
Address for correspondence: Miss Annabelle C Leong, Department of ENT, Wexham Park Hospital, Wexham, Slough SL2 4HL, UK. Fax: 01753 6333021 E-mail: annabelle.leong@btinternet.com
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Abstract

Introduction:

Due to problems with long waiting times for assessment of vertiginous patients (more than 24 weeks), we changed practice and instituted a pre-ENT balance clinic assessment; we then audited the results. In particular, we looked at the subgroup with benign positional paroxysmal vertigo.

Methods:

One hundred and fifteen patients were seen at the pre-ENT balance clinic from October 2003 to September 2004. Those diagnosed with benign positional paroxysmal vertigo received particle repositioning therapy at the same clinic and did not subsequently need ENT assessment.

Results:

By the end of the audit period, waiting times were reduced to three weeks, and more than one-quarter of vertiginous patients (i.e. those diagnosed with benign positional paroxysmal vertigo) did not need to be reviewed at an ENT clinic.

Conclusion:

We believe this to be the first study to present prospective data showing that patients with benign positional paroxysmal vertigo may be safely diagnosed and effectively managed at a pre-ENT balance clinic.

Keywords

Vestibular DiseasesBPPVBalance ClinicAudiologyParticle Repositioning Therapy

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 2 , February 2008 , pp. 132 - 138
Copyright
Copyright © JLO (1984) Limited 2007

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Footnotes

Presented at the British Academic Conference of Otolaryngologists, 5–7 July 2006, Birmingham, UK.

References

1 Yardley, L, Owen, N, Nazareth, I, Luxon, L. Prevalence and presentation of dizziness in a general practice community sample of working age people. Br J Gen Pract 1998;48:1131–5Google Scholar
2 Prokopakis, EP, Chimona, T, Tsagournisakis, M, Christodolou, P, Hirsch, BE, Lachanas, VA et al. Benign paroxysmal positional vertigo: 10-year experience in treating 592 patients with canalith repositioning procedure. Laryngoscope 2005;115:1667–71CrossRefGoogle ScholarPubMed
3 Kentala, E, Rauch, SD. A practical assessment algorithm for diagnosis of dizziness. Otolaryngol Head Neck Surg 2003;128:54–9CrossRefGoogle ScholarPubMed
4 Parnes, LS, Agrawal, SK, Atlas, J. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ 2003;169:681–93Google ScholarPubMed
5 Horak, FB, Jones-Rycewicz, C, Black, FO, Shumway-Cook, A. Effects of vestibular rehabilitation on dizziness and imbalance. Otolaryngol Head Neck Surg 1992;106:175–80CrossRefGoogle ScholarPubMed
6 Shepard, NT, Telian, SA. Programmatic vestibular rehabilitation. Otolaryngol Head Neck Surg 1995;112:173–82Google ScholarPubMed
7 Steenerson, RL, Cronin, GW. Comparison of the canalith repositioning procedure and vestibular habituation training in forty patients with benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 1996;114:61–4CrossRefGoogle ScholarPubMed
8 Jayarajan, V, Rajenderkumar, D. A survey of dizziness management in General Practice. J Laryngol Otol 2003;117:599–604CrossRefGoogle ScholarPubMed
9 Department of Health Modernisation Program: 10 High Impact Changes for Clinicians. http://www.wise.nhs.uk/sites/wisekmforum [26 December 2006]Google Scholar
10 Department of Health Policy and Guidance: Achieving Shorter Waits. http://www.dh.gov.uk/PolicyAndGuidance/PatientChoice [26 December 2006]Google Scholar
11 Department of Health: Modernising Workforce Planning. http://www.dh.gov.uk/PolicyAndGuidance/HumanResourcesAndTraining [26 December 2006]Google Scholar
12 Balance manual at Action on ENT 2000 http://www.wise.nhs.uk/sites/clinicalimprovcollab/ENT/pages [26 December 2006]Google Scholar
13 Hawkes, C. Smart handles and red flags in neurological diagnosis. Hosp Med 2002;63:732–42CrossRefGoogle ScholarPubMed
14 Lamont, AC, Alias, NA, Win, MN. Red flags in patients presenting with headache: clinical indications for neuroimaging. Br J Radiol 2003;76:532–5Google Scholar
15 National Census statistics 2001 for Slough, Bracknell Forest, Windsor and Maidenhead. http://www.statistics.gov.uk/census2001 [26 December 2006]Google Scholar
16 Werner, JF, Laszig, R. Portable videonystagmography. Int Tinnitus J 1996;2:143–4Google ScholarPubMed
17 Bance, ML, O'Driscoll, M, Patel, N, Ramsden, RT. Vestibular disease unmasked by hyperventilation. Laryngoscope 1998;108:610–14CrossRefGoogle ScholarPubMed
18 Yardley, L, Donovan-Hall, M, Smith, HE, Walsh, BM, Mullee, M, Bronstein, AM. Effectiveness of primary care-based vestibular rehabilitation for chronic dizziness. Ann Intern Med 2004;141:598–605CrossRefGoogle ScholarPubMed
19 Bath, AP, Walsh, RM, Ranalli, P, Tyndel, F, Bance, ML, Mai, R et al. Experience from a multidisciplinary “dizzy” clinic. Am J Otol 2000;21:92–7CrossRefGoogle ScholarPubMed
20 Heaton, JM, Barton, J, Ranalli, P, Tyndel, F, Mai, R, Rutka, JA. Evaluation of the dizzy patient: experience from a multidisciplinary neurotology clinic. J Laryngol Otol 1999;113:19–23CrossRefGoogle ScholarPubMed
21 Reeves, DJ, Alborz, A, Hickson, FS, Bamford, JM, Gosden, T. Community provision of hearing aids and related audiology services. Health Technol Assess 2000;4:1–120CrossRefGoogle ScholarPubMed