Objective: To systematically evaluate the full spectrum of self-reported chronic symptoms in patients with unilateral vestibular hypofunction (UVH) and to investigate the effect of interventions on these symptoms.Methods: A systematic review was conducted following the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Statement (PRISMA). A literature search was performed in Pubmed, Web of Science, Embase, and Scopus to investigate self-reported symptoms and self-report questionnaires in patients with UVH. All original studies ranging from full-text clinical trials to case reports, written in English, German, and French, were included. The frequency of self-reported symptoms was presented. For self-report questionnaires, a meta-analysis was carried out to synthesize scale means by the pre- and post-intervention means and mean changes for studies that investigated interventions.Results: A total of 2,110 studies were retrieved. Forty-seven studies were included after title-abstract selection and full-text selection by two independent reviewers. The symptoms of UVH patients included chronic dizziness (98%), imbalance (81%), symptoms worsened by head movements (75%), visually induced dizziness (61%), symptoms worsened in darkness (51%), and oscillopsia (22%). Additionally, UVH could be accompanied by recurrent vertigo (77%), tiredness (68%), cognitive symptoms (58%), and autonomic symptoms (46%). Regarding self-report questionnaires, UVH resulted on average in a moderate handicap, with an estimated mean total score on the Dizziness Handicap Inventory (DHI) and the Vertigo Symptom Scale (VSS) of 46.31 (95% CI: 41.17–51.44) and 15.50 (95% CI: 12.59–18.41), respectively. In studies that investigated the effect of vestibular intervention, a significant decrease in the estimated mean total DHI scores from 51.79 (95% CI: 46.61–56.97) (pre-intervention) to 27.39 (95% CI: 23.16–31.62) (post intervention) was found (p < 0.0001). In three studies, the estimated mean total Visual Analog Scale (VAS) scores were 7.05 (95% CI, 5.64–8.46) (pre-intervention) and 2.56 (95% CI, 1.15–3.97) (post-intervention). Finally, a subgroup of patients (≥32%) persists with at least a moderate handicap, despite vestibular rehabilitation.Conclusion: A spectrum of symptoms is associated with UVH, of which chronic dizziness and imbalance are most frequently reported. However, semi-structured interviews should be conducted to define the whole spectrum of UVH symptoms more precisely, in order to establish a validated patient-reported outcome measure (PROM) for UVH patients. Furthermore, vestibular interventions can significantly decrease self-reported handicap, although this is insufficient for a subgroup of patients. It could therefore be considered for this subgroup of patients to explore new intervention strategies like vibrotactile feedback or the vestibular implant.Systematic review registration: [https://www.crd.york.ac.uk/prospero/], identifier [CRD42023389185].

Background/Objectives: Chronic unilateral vestibular hypofunction (UVH) can lead to disabling vestibular symptoms and a decrease in quality of life. The aim of this study was to investigate etiologies, clinical subtypes, symptoms, and quality of life (QoL) in patients with chronic UVH. Methods: A retrospective study was performed on 251 UVH patients in a tertiary referral center. Inclusion criteria comprised reduced or absent caloric responses, with a caloric asymmetry ratio ≥25%. Patients with central vestibular pathology, symptom duration <3 months, and incomplete responses to questionnaires were excluded. Patient records were assessed for etiologies, secondary vestibular diagnoses, clinical subtypes, and questionnaires related to QoL. Additionally, multiple linear regression analysis was performed to evaluate factors influencing QoL. Results: Thirteen different etiologies were identified, with Menière’s Disease as the most prevalent (31%, n = 79). The most frequently reported secondary vestibular diagnoses were benign paroxysmal positional vertigo (BPPV) (21%, n = 54) and persistent postural perceptual dizziness (PPPD) (19%, n = 47). Five distinct clinical subtypes were identified: recurrent vertigo with UVH (47%), rapidly progressive UVH (25%), idiopathic/unknown UVH (18%), slowly progressive UVH (8%), and congenital UVH (2%). Over 80% of UVH patients experienced moderate-to-severe handicap, as indicated by the Dizziness Handicap Inventory. Approximately 20–25% of UVH patients exhibited moderate-to-severe depression and anxiety, based on the Hospital Anxiety and Depression Scale. Multiple linear regression analyses demonstrated that the presence of PPPD significantly reduced QoL in chronic UVH patients. Conclusions: Chronic UVH is a heterogeneous disorder. Secondary vestibular diagnoses like BPPV and PPPD often co-exist and can significantly impact QoL. A structured diagnostic approach and tailored interventions are crucial to address the diverse needs of UVH patients.

Objectives: Bilateral vestibulopathy (BVP) leads to unsteadiness when walking, which worsens in darkness or on uneven ground, as well as falls. Since simple balance tests struggle to distinguish between BVP and healthy participants, we aimed (1) to test if the Mini-BESTest is feasible in BVP, (2) how people with BVP perform on the Mini-BESTest and (3) to compare these scores with healthy reference data. Methods: Fifty participants with BVP completed the Mini-BESTest. 12-month falls incidence was obtained by questionnaire. To compare the overall and sub-scores between our participants with BVP and those of healthy participants from the literature (n = 327; obtained via PubMed searches), Mann–Whitney U tests were used. Sub scores within the BVP group were also compared. Spearman correlations were used to investigate the relationships between Mini-BESTest score and age. Results: No floor or ceiling effects were observed. Participants with BVP had significantly lower Mini-BESTest total scores than the healthy group. Anticipatory, reactive postural control and sensory orientation sub scores of the Mini-BESTest were significantly lower in BVP, while dynamic gait sub scores were not significantly different. A stronger negative correlation between age and Mini-BESTest total score was found in BVP than in the healthy group. Scores did not differ between patients with different falls history. Conclusion: The Mini-BESTest is feasible in BVP. Our results confirm the commonly reported balance deficits in BVP. The stronger negative association between age and balance in BVP might reflect the age-related decline in the remaining sensory systems with which people with BVP compensate.

Aim: To explore the full spectrum of symptoms and impacts associated with chronic unilateral vestibular hypofunction (UVH), and to assess whether these symptoms and impacts are fully covered by patient-reported outcome measures (PROMs) within the International Classification of Functioning, Disability and Health (ICF) framework.Methods: A qualitative study was conducted using semi-structured interviews, which were recorded, transcribed, and analyzed by two independent reviewers through a consensus approach. Data collection continued until thematic saturation was reached. Domains were then identified from interviews and PROMs (Dizziness Handicap Inventory, Hospital Anxiety and Depression Scale, EQ-5D-5L) using the ICF linking process. The analysis comprised three stages: (1), documenting the full spectrum of UVH symptoms and impacts from interviews, (2) reporting domains and constructs based on interviews, (3) comparing domains identified from interviews with those from PROMs (DHI, HADS, EQ-5D-5L, analyzed separately).Results: Fifteen patients with chronic UVH were interviewed. Reported symptoms revealed 16 physical symptoms, four cognitive symptoms, and five emotions. Key challenges included driving difficulties, darkness, sleep problems, fear of falling, and discomfort in crowded environments. Patients adapted certain behaviors, such as moving slowly, using supports, and avoiding sudden movements. Regarding the ICF framework, the most frequently reported construct was Body functions, with key domains including emotional, vestibular, and hearing-related functions. Activities and participation focused on maintaining body position and family relationships, while environmental factors highlighted the impact of light and sound. Interviews identified key domains related to vision, memory, multitasking, and activities impacting quality of life that were often overlooked by the PROMs.Conclusion: Patients with chronic UVH experience a wide spectrum of physical, cognitive, and emotional symptoms, resulting in significant limitations in daily life. The frequently used PROMs (DHI, HADS, and EQ-5D-5L) do not fully cover these symptoms and their impacts, which leave many aspects underrepresented. A tailored PROM for UVH may be needed, to better reflect the specific symptoms, behaviors and functional limitations related to chronic UVH.

Aims The aim of the study is to determine the acute stress and psychological resilience level of people with hearing impairment during the COVID-19 pandemic and to investigate the relationship between the grade of hearing impairment, psychological resilience and perceived stress level in this period. Methods A cross-sectional study. A total of 135 hearing-impaired individuals using hearing aids (study group) and 125 healthy individuals (control group) participated. Turkish versions of the Acute Stress Symptoms Scale (ASSS) and Brief Resilience Scale (BRS) were applied to all participants. Turkish version of Amsterdam Inventory for Auditory Disability and Handicap (T-AIADH) was also applied to the study group in addition to other scales. The presence of any difference between the groups in terms of ASSS and BRS scores was investigated. Results There was a statistically significant difference between the control group and the study group in terms of ASSS results (Z=-4.4, p=0.00). No statistically significant difference was found between the control group and the study group in terms of BRS scores (Z=-0.248, p=0.804). Furthermore, T-AIADH scale was observed not to correlate either with ASSS or BRS (p>0.05). In the study group, change in income level after the pandemic, age, and sex variables were determined as a significant predictor of ASSS. Conclusion Identifying risks and protective factors for hearing-impaired individuals at the early stage of the epidemic is considered to be of critical importance to predict the psychological impact of both the epidemic and the response to the COVID-19 health crisis, and to reduce stress.

Objectives. This systematic review was performed to investigate the co-occurrence of otologic disorders and benign paroxysmal positional vertigo (BPPV).Methods. Searches were conducted in PubMed and Web of Science. The review included all original English-language studies—ranging from full-text clinical trials to case reports—enrolling participants aged ≥18 years. Articles were classified into two groups: group 1 comprised studies reporting otologic disorders in patients diagnosed with BPPV; group 2 comprised studies reporting instances of BPPV among patients with otologic disorders. The frequency of each condition was analyzed using descriptive statistics. Meta-analyses were performed using a random-effects model to estimate overall prevalence in both groups.Results. The initial search yielded 3,407 records, of which 68 articles were included in the analysis. In group 1 (19 studies), 11.4% of patients with BPPV (932/8,157) had co-occurring otologic disorders. Sudden sensorineural hearing loss (present in 11.9% of patients in relevant included studies) and acute unilateral vestibulopathy/vestibular neuritis (5.0%) were most frequently reported. Meta-analysis produced pooled prevalence rates of 11.8% (95% CI, 3.1%–35.7%) for sudden sensorineural hearing loss and 6.5% (95% CI, 3.7%–11.2%) for acute unilateral vestibulopathy/vestibular neuritis. In group 2 (49 studies), 9.7% of patients with otologic disorders (1,106/11,457) experienced concurrent BPPV, with Menière’s disease exhibiting the highest rate of concurrence (10.2%). Meta-analyses showed pooled prevalence rates of 10.4% (95% CI, 6.2%–16.8%) for acute unilateral vestibulopathy/vestibular neuritis and 9.1% (95% CI, 4%–19.1%) for Menière’s disease.Conclusion. The co-occurrence of otologic disorders and BPPV is prevalent. These findings underscore the need for mutual clinical screening and may inform understanding of the etiologies underlying BPPV.