The Journal of International
Advanced Otology
Original Articles

Constant Dizziness Versus Episodic Vertigo in Ménière’s Disease: Health-Related Quality of Life, Cognitive Dissonance, and Postural Problems

1.

Department of Otorhinolaryngology – Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland

2.

Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of the Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China

3.

Tampere University Faculty of Information Technology and Communication Sciences, Tampere, Finland

4.

Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA

5.

UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, Colorado, USA

6.

Virtual Hearing Lab, Collaborative initiative between University of Colorado School of Medicine and University of Pretoria, Aurora, Colorado, USA

7.

Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa

8.

Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India

J Int Adv Otol 2024; 20: 417-425
DOI: 10.5152/iao.2024.231113
Read: 115 Downloads: 52 Published: 27 September 2024

Background: The aim was to explore and characterize dizziness and vertigo (constant vs episodic) and associated problems in patients with Ménière’s disease (MD) to allow characterization of the impact of the disease.

Methods: The study used a retrospective survey design. A total of 539 people with MD participated in this study. The online questionnaire included 36 items which had mixture of structured and open-ended questions that were focusing on MD symptoms, impact of their symptoms, vestibular rehabilitation, as well as health-related quality of life (HRQoL).

Results: Forty-six percent of the patients had episodic vertigo, 6% had constant dizziness, 15% had both episodic vertigo and constant dizziness, and 31% did not have vertigo or dizziness within the last 2 years. Patients with MD without any vertigo rated their HRQoL as 73.9%, those with episodic vertigo as 71.1%, those with constant dizziness as 56.9%, and those with constant dizziness and episodic vertigo as 57.9% indicating significant reduction in HRQoL in constant dizziness patients. Constant dizziness was associated with cognitive visual problems, fatigue, balance problems, vestibular drop attacks and syncope. The impact of balance problem was more severe among those with constant dizziness. The most common balance problem was tripping-off (34%), followed by swaying (25%) or rocking (8%) sensations. In the self-administered rehabilitative training, there were no differences between any of the vertigo or dizziness groups although disease profile of MD differed significantly.

Conclusion: We emphasize that constant dizziness in MD constitutes a long-term maladaptation to a vestibular and visual cognitive function causing cognitive dissonance. Different types of vertigo and their associated complaints require different treatment strategies to the manage balance problems and to cope with the disease, but best practices is still under research.

Cite this article as: Pyykkö, I, Zou, J, Manchaiah V. Constant dizziness versus episodic vertigo in Ménière’s disease: health-related quality of life, cognitive dissonance, and postural problems. J Int Adv Otol. 2024;20(5):417-425.

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