Journal article
The clinical value of a thorough diagnostic evaluation for neurotologic complaints
American journal of otolaryngology, v 40(1), pp 16-21
Jan 2019
PMID: 30243840
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Determine the clinical efficacy of comprehensive neurotologic testing in patients presenting with complaints of hearing loss, tinnitus and/or dizziness.
This is a retrospective analysis of 1170 consecutive charts of patients who presented between 1980 and 2013 with neurotologic complaints. Demographic data, chief complaint, diagnostic imaging, audiograms, and blood tests were evaluated.
Retrospective analysis of 1170 patient charts was performed. 762/1170 (65%) patients presented with subjective hearing loss, 575/1170 (49%) with dizziness, and 657/1170 (56%) with tinnitus. Audiometric testing revealed hearing loss in 1059/1169 (91%) patients. 536/1120 (48%) patients had abnormalities on Magnetic Resonance Imaging, and 343/1087 (32%) on Computed Tomography imaging. Endocrine and immunologic testing revealed 108/1135 (9.5%) patients were hyperglycemic; 125/1124 (11%) patients had elevated TSH; 149/1141 (13%) patients had a positive ANA; and 82/1133 (7.2%) patients were positive for RF. 198/1083 (18%) of patients were positive for HLA-B35, 246/1083 (23%) for HLA-Cw4, 454/1083 (42%) for HLA-Cw7, and 747/1060 (70%) of patients had absent HLA-DR4. 112/1085 (10%) of patients were positive for anti-68kD antibodies and 154/936 (17%) for protein 0. Many patients were diagnosed with previously unrecognized medical conditions.
Comprehensive neurotological workup results in diagnoses that would go unrecognized otherwise, allowing patients to receive prompt treatment for medically important conditions, some of which may be causally related to their neurotologic complaints. However, the value of each study for routine testing of patients with neurotologic complaints remains controversial; and the evidence presented herein should help practitioners determine what studies should be included in their patient assessments.
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Details
- Title
- The clinical value of a thorough diagnostic evaluation for neurotologic complaints
- Creators
- Natalie A. Krane - Oregon Health & Science UniversityBrian McKinnon - Drexel UniversityMichelle White - Tufts Medical CenterDani Ashak - Kaiser PermanenteEileen L. Chang - Nassau University Medical CenterDaniel Park - University of California, IrvineSandeep Segar - Department of Hospital Medicine, University of California, San Diego, San Diego, CA, United States of America.Jeyanthan Jayakumaran - Drexel UniversityClara Grayhack - Drexel UniversityRobert T. Sataloff - Drexel University
- Publication Details
- American journal of otolaryngology, v 40(1), pp 16-21
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine; Otolaryngology (and Head and Neck Surgery)
- Web of Science ID
- WOS:000453638400003
- Scopus ID
- 2-s2.0-85053687350
- Other Identifier
- 991019168774104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Otorhinolaryngology