The use of vestibular evoked myogenic potentials (VEMP) in the diagnosis of otolithic dysfunction of patients with obstructive sleep apnea: a survey of awareness and recognition of otorhinolaryngology medical staffs.

PURPOSE: To assess awareness and recognition of vestibular function tests in otorhinolaryngology medical staffs, especially the vestibular evoked myogenic potentials (VEMP) testing in patients with obstructive sleep apnea (OSA). METHODS: A survey was delivered via either email or a social media app. The medical staffs of the Chinese Medical Association of Otolaryngology Head and Neck Surgery from various branches were enrolled. Study data were collected and managed with an online data collection tool. RESULTS: A total of 1781 emails and 623 social media messages were sent to 2404 otorhinolaryngology medical staffs. One hundred and fifty-seven of them participated in the survey, including 24 via emails and 133 via the social media app. Regarding the knowledge of VEMP, only 59 (37.6%) of them agreed that OSA could be related to vertigo/dizziness/imbalance and 28 (17.8%) believed that OSA could result in VEMP abnormalities and would factor this in diagnosing the impairment of the vestibular function of OSA patients. A total of 7.6% of the respondents had never heard of the VEMP tests. Responses regarding the minimum age at which VEMP are possible ranged from younger than 6 months to greater than 18 years of age. Beliefs regarding the utility and reliability of VEMP varied, with 'unsure' being the most frequent response. In addition, only 17.8% of otolaryngologists indicated some access to the VEMP test. CONCLUSIONS: Knowledge and beliefs about the role of VEMP in diagnosing otolithic organ dysfunction caused by OSA in otorhinolaryngology vary widely. It is important for otorhinolaryngology medical staffs to learn the latest literatures and updated knowledge through continuing education.

[Importance of re-examinations in the diagnosis of benign paroxysmal positional vertigo].

OBJECTIVE: To evaluate the importance of re-examinations in the diagnosis of benign paroxysmal positional vertigo (BPPV) and its clinical characteristics. METHODS: The medical records of 288 BPPV patients treated during January 2009 to December 2010 were reviewed and analyzed. The definite diagnosis was established by re-examinations. RESULTS: Among them, 39 (13.5%) were diagnosed by re-examinations or return visits. And 25 patients received a correct diagnosis on the first visit and 14 were diagnosed on return visits. Their ages, gender distribution and the times of particle-repositioning maneuver were the same as the overall profiles. The rate of horizontal semicircular canal BPPV was higher in the 39 re-examined patients than the overall rate (46.15% vs 22.22%). And the latencies decreased during the second examination in 18 patients. CONCLUSION: Re-examinations and return visits are useful for diagnostic clarifications in the suspected BPPV patients.