Improving patients’ quality of life (QOL) is a crucial goal of medical care. Consequently, recent clinical research and evaluations have increasingly focused on patient-reported outcomes (PRO). PROs are a direct subjective assessment of the patients’ feelings, including their fears and anxieties, and provide critical insights into patients’ experiences. In addition to these subjective assessments, incorporating objective measures, for example, balance ability testing for evaluating the risk of falls, are also essential. Objective measures enable, for example, predicting the risk of falls, assessing the effectiveness of therapeutic interventions, developing treatment plans, and comparing different therapeutic outcomes. This comprehensive approach enhances patient safety and improves the QOL of the patients, particularly in the area of fall prevention. This article focuses on falls and reviews the usefulness of questionnaires and performance tests focused on falls and balance ability. We introduce clinically useful test batteries that provide valuable information for healthcare professionals. Combining subjective and objective measures supports clinical and medical evaluation, preventing falls and enhancing the patient QOL.

The mouse has been a practical animal model for studying the inner ear. Understanding the anatomy of the murine inner ear is essential when delivering drugs or vectors for therapeutic studies. In addition, a knowledge of dissection techniques is necessary for performing immunohistological examinations of the cochlea and vestibule. However, there have been few comprehensive reports describing these techniques to date. In this paper, I summarize the anatomical knowledge and methods for whole-mount dissection of the murine inner ear, providing a practical guide to advance our understanding of the inner ear physiology and pathology using mouse models.

One of the most typical symptoms of patients encountered in outpatient otorhinolaryngology clinics is dizziness. We conducted a study on the real-world outpatient practices for first-time otorhinolaryngology patients presenting with the chief complaint of dizziness, in order to improve the clinical practices and support the education of otorhinolaryngology majors. The subjects of the study were a total of 254 patients who first visited the outpatient otorhinolaryngology departments of one of the eight participant hospitals between August 2018 and July 2019 with the chief complaint of dizziness or related symptoms, such as rotatory vertigo, disorientation, or a floating sensation. Data of the outpatients at their first visit were extracted by a retrospective chart review and using the Dizziness Checklist that was created prior to the data collection.

The patients ranged in age from 6 to 92 years, with a mean age of 61 years. The ratio of men to women was approximately 2:3. Of the patients, 43% had another outpatient otorhinolaryngology visit, while the remaining patients visited only once. The likelihood of a second outpatient visit was significantly higher in patients with nystagmus.

The rates of performance of the equilibrium function tests of stabilometry, VOR (to manual rotation stimulation of the examination chair), caloric test, vHIT, and VEMP were 45.7%, 30.7%, 5.1%, 4.7%, and 2.0%, respectively. In contrast, the rates of performance of nystagmus testing and conventional pure tone audiometry were 98.4% and 93.7%, respectively. To determine the relationship between the presence of dizziness consultant physicians certified by the Japan Society For Equilibrium Research and the rates of performance of equilibrium function tests, we compared the rates in cases that visited hospitals with (151 cases) and without (103 cases) dizziness consultant physicians; the results revealed higher rates of performance of equilibrium function tests in the hospitals with dizziness consultant physicians.

Introduction: Sarcoidosis is an multisystem inflammatory disease of unknown cause characterized by the presence of non-caseating granulomas in the affected tissues, most often involving the lungs, skin, lymph nodes, and eyes. Neurosarcoidosis, which refers to involvement of the central nervous system in patients with sarcoidosis, is said to account for about 5% of all cases of systemic sarcoidosis. Herein, we report a case of sarcoidosis that presented with right hearing loss and dizziness and subsequently developed left facial nerve paralysis.

Summary: A 51-year-old woman developed right ear fullness and right hearing loss on December 1, 20XX. She experienced dizziness for the first time on December 9. She visited her previous doctor on December 13. After a hearing test, she was diagnosed as having sudden hearing loss on the right side with dizziness, and was referred to our department for further examination and treatment. Thereafter, she developed left facial nerve paralysis. We diagnosed the patient as having disorder of the right cochlear nerve (VIII), bilateral superior vestibular nerves (VIII), and left facial nerve (VII) as part of neurosarcoidosis. She continues to receive treatment with a steroid.

Persistent Postural-Perceptual Dizziness (PPPD) is a chronic functional vestibular disorder characterized by exacerbation of symptoms by standing, movements, and/or visual stimulation. The Niigata PPPD Questionnaire (NPQ) is an effective screening tool for identifying PPPD, typically with a score of 27 or higher. However, NPQ scores of 27 or more can also occur in diseases other than PPPD.

We examined the prevalence of NPQ scores of 27 or higher among patients with vestibular symptoms lasting for more than 3 months and explored the diagnoses and clinical features of cases with elevated NPQ scores that were not diagnosed as PPPD.

A retrospective study was conducted from January 2019 to March 2023 on 1,296 patients who presented to Nagoya City University Hospital’s Otorhinolaryngology Department with vestibular symptoms. Of these, 696 patients met the criteria of being ≥18 years and suffering from vestibular symptoms for more than 3 months. Of the 696 patients, 558 completed the NPQ, Dizziness Handicap Inventory (DHI), and Hospital Anxiety and Depression Scale (HADS) questionnaires at their initial visit.

More than half of the non-PPPD cases had NPQ scores of 27 or higher. Among the patients with elevated NPQ scores, in patients with PPPD, a correlation was noted between the NPQ scores and the severity of the vestibular symptoms, whereas correlations with scores on the depression and anxiety scales were less pronounced. In contrast, in patients with conditions such as Meniere’s disease, benign paroxysmal positional vertigo (BPPV), and vestibular migraine, while the NPQ scores were not correlated with the severity of the vestibular symptoms, the severity of the symptoms correlated closely with the scores on the depression and anxiety scales.

In patients with vestibular disorder, unilateral damage of the peripheral vestibular function manifests as vertigo and disequilibrium; with recovery of the vestibular system (so-called vestibular compensation), the dizziness and disequilibrium gradually improve. However, there are cases of chronic peripheral vestibular dysfunction in which vestibular compensation is delayed and dizziness and disequilibrium persist. Chronic peripheral vestibular dysfunction does not respond to drug therapy, and vestibular rehabilitation is expected to become the major treatment modality.

Our team included physicians and physical therapists who worked together to evaluate the dizziness symptom, vestibulo-oculomotor function, balance function, gait function, and quality of life in patients presenting with dizziness and disequilibrium, in order to devise a vestibular rehabilitation program for patients with chronic dizziness. Herein, we present our vestibular rehabilitation program for patients with chronic peripheral vestibular dysfunction and its therapeutic effects, as well as our vestibular rehabilitation approach for persistent postural-perceptual dizziness.