The Diagnostic Role of Advanced Vestibular Testing Systems in Identifying Rarely Diagnosed Peripheral Vestibular Disorders in the Population
Project no. 25240 · Status: Kapanmış (Yayın bekleniyor) · 2022
Summary
<p>Dizziness and imbalance are among the most common complaints encountered in both emergency medicine and non-acute outpatient clinics, accounting for 1-2% of outpatient consultations. Approximately 20% to 30% of the general population is affected by vertigo. While studies on vertigo and balance problems in the literature largely rely on questionnaires and survey tools, the diagnostic range of both peripheral and central vertigo pathologies has expanded significantly, particularly with the development of digital diagnostic devices in the last decade. Advanced objective analysis of vestibular system pathologies has led to misdiagnoses in the past, leading to the application of incorrect treatment options. Chronic peripheral vestibular pathologies, which can be quite challenging to diagnose with traditional physical examinations and diagnostic tools, can be diagnosed with advanced, current objective methods. However, there is still no consensus on diagnostic algorithms, and the effectiveness of virtual vestibular rehabilitation programs in treating these pathologies remains unclear. However, studies worldwide using objective digital diagnostic tests to examine the pathognomic findings of chronic vestibular pathologies in large patient series, as well as the responses to current vestibular rehabilitation treatments, are quite limited. While the diagnosis of unilateral and bilateral chronic vestibular dysfunction used to be limited to symptom assessment, objective diagnostic tests analyzing the vestibulo-ocular reflex arc are increasingly gaining ground. Vestibular rehabilitation, which optimizes the vestibular compensation process, has been rapidly evolving in recent years in parallel with these rapidly evolving objective vestibular analysis techniques. Following the understanding of conventional vestibular rehabilitation mechanisms, vestibular diagnostic analysis models adapted to virtual reality simulation are a new field that has recently been developed and has received relatively limited research. The combined use of current objective vestibular diagnostic and monitoring tools with traditional physical examination methods allows for the establishment of difficult diagnoses often overlooked in primary and secondary care in patients with chronic peripheral vertigo and the selection of appropriate treatment modalities. In parallel, it is anticipated that incorporating virtual reality vestibular rehabilitation applications into the diagnostic process may be effective in accurately diagnosing these conditions. Dizziness symptoms often do not differ significantly from those of peripheral vertigo, and even a detailed history and examination can sometimes make it difficult to reach a differential diagnosis. Diseases can overlap and sometimes present as overlapping syndromes. While different patterns of multiple disease manifestations can be observed in the same patient, sometimes the same disease can present atypically. Conventional tests are sometimes insufficient to differentiate between the factors that cause dizziness during these illnesses, making differential diagnosis difficult. For these reasons, this project aims to explore the role of advanced objective diagnostic tests in the diagnosis of chronic peripheral vertigo, which is difficult to diagnose and cannot receive effective treatment, to identify pathognomonic findings in these tests, and to develop diagnostic algorithms with high sensitivity and specificity.</p>