Vestibular disorders in patients with postural instability at the naval hospital of high specialty

Author: 
Dr. Manuel Antonio Castañeda Cabrera, Dr. Francisco Javier Mancilla Mejía and Dra. Mabel Yolitzin Peláez Ricaño

Introduction: The disorders that alter the function vestibular are a major public health problema, both clinical as economic perspective. Objective: To identify vestibular disorders in patients with postural instability at The Naval High Specialty Hospital. Material and Methods: A cross-sectional, non-randomized, descriptive and ambispective study was conducted, as well as a systematic review and analysis of the clinical records of each evaluated patient at the Otorhinolaryngology service, reported with postural instability symptom (dizziness, vertigo, latero-pulsion , Postural instability) as the main reason for medical care. The SPSS 19.0 statistical package for Windows was used for the data analysis. 2 x 2 factorial design to estimate prevalence. The bivariate analysis was performed with the χ2 test, considering a p≤0.05. Student's t, Mann-Whitney U, and Kruskal-Wallis tests were used as well. A p≤0.05 was considered significant. Results: A total of 1077 files reviewed, 374 patients with different peripheral vestibular disorders were obtained. Of the total sample (n = 374), 71.7% (268) are of the female gender and 28.3% (106) are male. The mean age +/- standard deviation is 55.7 +/- 16.4 years, with an age range of 18-95 years. The prevalence of benign paroxysmal postural vertigo (BPPV) is 84.0%, endolymphatic hydrops with 11.5%, posttraumatic vertigo 4.5%, vestibular neuronitis 2.4% and 5.6% with Menieré's disease, perilymphatic fistula, otosyphilis and upper semicircular canal dehiscence did not reach the 1%. Conclusions: The prevalence of vestibular disorders is similar to that reported at literature, benign paroxysmal postural vertigo the most frequent. Consequently, and differing from the literature, the endolymphatic hydrops is the second most prevalent vestibular pathology, followed by Menieré's disease and, in lower frequency the vestibular neuritis, contrasting widely with it reported in the literature. Therefore, it is essential not only to carry out extension studies but also a complete clinical evaluation in order to establish a specific diagnosis of the vestibular disorders that affect our population that is suffering postural instability.

Paper No: 
1157