Assessing bilateral vestibulopathies: integrating VHIT and DHI for clinical insights and functional outcomes.

BACKGROUND

Bilateral vestibulopathy (BVP) is a rare disorder that markedly reduces quality of life through impaired vestibulo-ocular reflex and related symptoms.

AIMS/

OBJECTIVES

This study aimed to describe the etiological features of BVP and assess functional outcomes using subjective and objective tools.

MATERIAL AND

METHODS

A retrospective review was conducted in 31 patients with BVP. Demographic data, etiologies, and comorbidities were analyzed. Functional outcomes were evaluated with Dizziness Handicap Inventory (DHI) and video Head Impulse Test (vHIT). Statistical analyses examined correlations between these measures.

RESULTS

The mean age was 55 ± 16 years. Idiopathic cases comprised 19.4%, while ototoxicity was the most frequent cause (41.9%), mainly aminoglycosides (29%). Advanced age and comorbidities were risk factors for ototoxicity. Mean DHI score was 59 ± 21, with highest scores in ototoxic cases. Mean vHIT gains were 0.37 ± 0.17 (right) and 0.36 ± 0.20 (left), with lowest values in ototoxicity. A significant negative correlation existed between vHIT gains and DHI scores (r=-0.616, p < 0.001).

CONCLUSIONS AND SIGNIFICANCE: In our retrospective cohort, ototoxic medications appear to be the leading cause of BVP, especially among older patients with comorbidities. The inverse relationship between vHIT and DHI highlights the need to integrate both assessment methods for comprehensive evaluation. These findings emphasize ototoxicity awareness and validate complementary use of objective and subjective assessments.