Objectives: Assess the outcomes of a multidisciplinary one-stop balance clinic in a tertiary hospital.
Design: Retrospective analysis of new referrals seen over a 3-year period (2008-2010).
Setting: Multidisciplinary one-stop balance clinic in a tertiary referral centre.
Main outcome measures: Analysis of the demographics, referral source, investigations, diagnoses and outcomes of the one-stop balance clinic
Results: 148 new patients, 52 men and 96 women with a mean age of 53.9 years (range 18-84) were seen. General practitioners referred 81% of cases. Sixty patients underwent further investigations, imaging, vestibular function and other audiological tests. 71% of patients had true vertigo. Eighty-five patients (57%) had vertigo due to an otological disorder and peripheral labyrinthine causes accounted for 64% of referrals both with and without the symptom of vertigo. Common diagnoses included (i) BPPV, (ii) Meniere’s disease or a variant, (iii) psychogenic causes such as anxiety and central causes such as migrainous vertigo and vestibular neuronitis. The majority of patients (64%) had a one-stop diagnosis and treatment plan. The remaining cases requiring follow-up were mainly those with middle ear disease being followed-up in general clinics and Meniere’s disease.
Conclusion: Our study suggests that almost two thirds of patients requiring an opinion from a secondary/tertiary care balance centre can be managed in a single appointment. It also confirms the appropriateness of the majority of primary care referrals. The level of follow up and further investigation we feel confirms the efficiency of a dedicated supra-specialist led balance clinic model.
Abbreviations: BPPV – Benign paroxysmal positional vertigo
DOH – Department of Health
VEMPs - Vestibular-evoked myogenic potentials
VFTs – Vestibular function tests