Introduction of video head impulse testing to an ENT outpatient clinic: objective vestibular evaluation at first point of contact

摘要

Objective: Monitor the impact of Video Head Impulse Testing (vHIT) conducted during initial ENT consultations on diagnosis rates and requirement for onward referral for further laboratory-based vestibular testing. Design: Prospective service evaluation audit. Setting: ENT outpatients department of a tertiary balance service within a University Teaching Hospital. Main outcome measures: The capability of vHIT to identify vestibular pathology was recorded in 100 consecutive dizzy patients prospectively enrolled into the study. Diagnosis rates at first appointment, as well as the need to onward refer for further vestibular testing, were noted. Results: Of the 100 new patients seen with dizziness, 85% were diagnosed and managed by the end of the first appointment. VHIT was conducted in 83% of cases and provided clinically useful information that aided diagnosis in over 90% of these cases. Conclusions: vHIT is a safe, quick and noninvasive way of obtaining clinically useful information relating to the function of all three semicircular canal pairs within an ENT outpatient clinic. It does not replace advanced vestibular testing but acts as a useful adjunct that can be used to reach a diagnosis more quickly and thereby provide a more efficient patient centred model of care.