J Löhler1,2,3, D Eßer4, B Wollenberg5, L E Walther6,7,8. 1. Klinik für HNO-Heilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland. loehler@hno-aerzte.de. 2. Deutsches Studienzentrum für HNO-Heilkunde, Kopf- und Halschirurgie (DSZ-HNO), Bonn, Deutschland. loehler@hno-aerzte.de. 3. HNO-Praxis, Maienbeeck 1, 24576, Bad Bramstedt, Deutschland. loehler@hno-aerzte.de. 4. Klinik für Hals‑, Nasen- und Ohrenheilkunde, Plastische Operationen, HELIOS Klinikum Erfurt GmbH, Erfurt, Deutschland. 5. Klinik für HNO-Heilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland. 6. Deutsches Studienzentrum für HNO-Heilkunde, Kopf- und Halschirurgie (DSZ-HNO), Bonn, Deutschland. 7. HNO-Gemeinschaftspraxis Main-Taunus-Zentrum, Sulzbach (Taunus), Deutschland. 8. Universitäts-HNO-Klinik, Mannheim, Deutschland.
Abstract
BACKGROUND: Dizziness and vertigo are some of the most common reasons for seeking medical help. Acute dizziness and vertigo require interdisciplinary cooperation. New diagnostic methods (the video head impulse test) and modern algorithms (HINTS: head impulse test/nystagmus [direction changing]/test-of-skew) are increasingly used in case of the acute vestibular syndrome in emergency care. METHODS: In a survey on the management and participation of the ENT specialist area, the authors interviewed 168 German ENT clinics during the spring of 2017 using an online survey. RESULTS: Of the 168 departments, 100 departments participated in the survey. The specialties with first medical contact in cases with acute vertigo were ENT (48%), neurology (32%), and internal medicine (17%). Most of the patients were hospitalized. Patients with acute dizziness were referred most commonly to the ENT (62%) and neurology (16%) departments for further therapy, rarely, to internal medicine wards. For emergency diagnostic workup, the video head impulse test is frequently used in ENT (72%). CONCLUSIONS: In acute vertigo syndromes, the ENT physician has a special role and responsibility in the interdisciplinary workup, since ontological disorders are the most common cause. In any case, an ENT consultation is recommended. In German emergency departments, otorhinolaryngologists use modern diagnostic tools and algorithms such as the video head pulse test and HINTS to objectify peripheral vestibulopathy or identify central causes. Thus, this is a contribution to improving medical care.
BACKGROUND:Dizziness and vertigo are some of the most common reasons for seeking medical help. Acute dizziness and vertigo require interdisciplinary cooperation. New diagnostic methods (the video head impulse test) and modern algorithms (HINTS: head impulse test/nystagmus [direction changing]/test-of-skew) are increasingly used in case of the acute vestibular syndrome in emergency care. METHODS: In a survey on the management and participation of the ENT specialist area, the authors interviewed 168 German ENT clinics during the spring of 2017 using an online survey. RESULTS: Of the 168 departments, 100 departments participated in the survey. The specialties with first medical contact in cases with acute vertigo were ENT (48%), neurology (32%), and internal medicine (17%). Most of the patients were hospitalized. Patients with acute dizziness were referred most commonly to the ENT (62%) and neurology (16%) departments for further therapy, rarely, to internal medicine wards. For emergency diagnostic workup, the video head impulse test is frequently used in ENT (72%). CONCLUSIONS: In acute vertigo syndromes, the ENT physician has a special role and responsibility in the interdisciplinary workup, since ontological disorders are the most common cause. In any case, an ENT consultation is recommended. In German emergency departments, otorhinolaryngologists use modern diagnostic tools and algorithms such as the video head pulse test and HINTS to objectify peripheral vestibulopathy or identify central causes. Thus, this is a contribution to improving medical care.
Entities:
Keywords:
Emergency medical services; Head impulse test; Peripheral vestibulopathy; Stroke; Vestibular function tests
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