An approach to imaging the dizzy patient.
Disease of the vestibular system involves a lengthy differential diagnosis, from the relatively trivial to potentially life-threatening conditions. As a definitive specific diagnosis is often difficult to make, imaging may be used simply to "rule out" serious pathology. In this context, suboptimal imaging choices may be unnecessarily expensive and may fail to document the pathology. In contrast, an orderly investigation includes appropriate audiometric and vestibular tests, which when reviewed in the clinical context, indicate the most pertinent imaging modalities. This enables the clinician to plan a cost-effective, definitive imaging strategy. This review considers the role of imaging in an integrated approach to investigating the dizzy patient. A discussion of vestibular pathology is presented to assist in the review, and several cases are provided as examples.
MacDonald
C B
CB
Department of Otolaryngology-Head and Neck Surgery, Boston University School of Medicine, MA, USA.
Melhem
E R
ER
D000368:Aged; D001299:Audiometry; D002675:Child, Preschool; D003952:Diagnostic Imaging; D004244:Dizziness / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015837:Vestibular Diseases / Q000150:complications / Q000175:diagnosis*; D014724:Vestibular Function Tests; D014722:Vestibule, Labyrinth / Q000503:physiopathology