Keynote lecture about vestibular implant technology

Scientific and clinical insights from vestibular implant clinical studies

Innovations and Technology in diagnosis and management of Vestibular Disorders

Background: Chronic unilateral vestibular hypofunction (UVH) is a disabling condition characterized by persistent imbalance, dizziness, and a significant decline in quality of life (QoL). Despite its clinical relevance, the long-term symptomatology and functional burden associated with chronic UVH remain under-characterized.

Outcome objectives: This lecture presents an integrated overview of five studies conducted as part of a PhD project to advance our understanding of chronic UVH from multiple dimensions, including symptom burden, diagnostic complexity, and patient-reported outcomes.

Description: The first study is a systematic review and meta-analysis that consolidates chronic symptom profiles in UVH and examines the effect of various interventions on symptom resolution. Findings highlight the heterogeneity and persistence of symptoms even after vestibular interventions.

Building on these findings, in the second study, a qualitative study using the International Classification of Functioning, Disability and Health (ICF) framework explored the full spectrum of symptoms and their life impact through in-depth interviews with 15 patients. This study highlighted several crucial domains that are rarely captured by traditional self-report tools.

In the third study, a retrospective cohort analysis of 251 patients evaluated the underlying etiologies, clinical subtypes, and frequent co-diagnoses. The QoL was assessed across domains, and potential predictors of poor QoL were identified.

To contextualize UVH burden, the fourth study compared QoL outcomes between patients with chronic UVH and those with bilateral vestibulopathy (BVP). Both disease-specific and general health PROMs were used, alongside normative population data. This comparison emphasized that chronic UVH, while often perceived as “less severe,” is associated with a substantial and comparable QoL decline to BVP.

Finally, the fifth study tested the validity and reliability of the Bilateral Vestibulopathy Questionnaire (BVQ) in chronic UVH patients. Psychometric analysis supported its adapted use in this population, suggesting it may fill an important gap in outcome measurement.

Collectively, these studies provide a comprehensive, multi-method evaluation of chronic UVH and propose practical strategies to improve diagnosis, monitoring, and patient-centered care.

Surgical Treatment of Meniere's disease

Course Description — The course will begin with a didactic overview of new developments in diagnosis and management of patients with PPPD (8 minutes), continue with a case-based discussion highlighting common challenges in diagnosis and treatment that will be conducted interactively with the audience (17 minutes), and conclude with time for open questions from the audience (5 minutes).

Outcome Objectives — At the conclusion of this course, audience members will be able to: (1) incorporate simple screening tools into their practices to identify patients who are at risk for developing PPPD and those who likely have the disorder, (2) confidently manage the diagnostic evaluation of patients with PPPD, (3) educate patients about pathophysiologic mechanisms underlying PPPD to help them understand the diagnosis and rationale for each treatment intervention, and (4) coordinate effective multi-disciplinary treatment plans for patients with PPPD and commonly comorbid conditions.

Background — The chronic vestibular disorder of persistent postural-perceptual dizziness (PPPD) was defined by the Barany Society for the International Classification of Vestibular DIsorders in 2017. Since then, clinical epidemiologic investigations have found PPPD to be the most common cause of chronic vestibular and balance symptoms in otology/neurotology and vestibular medicine. Systematic research also has advanced knowledge about its differential diagnosis, likely pathophysiologic mechanisms, and expected outcomes of available treatments. This information has improved our ability to efficiently and effectively detect and treat patients with PPPD. The course will provide attendees with a review of these developments with an emphasis on practical applications for clinical practice and awareness of ongoing investigations by research teams worldwide.