Pure tone tests and beyond in audiological evaluations of middle ear pathologies-Points to consider in audiological evaluations for middle ear pathologies

The Hyperventilation test is commonly used in the vestibular bedside examination. It can identify latent vestibular asymmetry that causes nystagmus, which may occur either towards the healthy side (paretic nystagmus) or towards the affected side (irritative nystagmus). During the early stage of acute unilateral vestibulopathy, Hyperventilation-Induced Nystagmus is observed in many cases, manifesting as either paretic (which reinforces spontaneous nystagmus) or irritative (which inhibits or reverses spontaneous nystagmus). The differences between the paretic and irritative patterns can help differentiate between whether the acute damage has a neuritic or vascular origin.

A symposium will cover all aspects related to BPPV

from history taking up to most recent methods of treatment and prevention of recurrences

Objectives : to draw a road map of management of cases of BPPV

outcome : the participants will get full knowledge of how to confirm the diagnosis and the best scenario for treatment And prevention of the recurrence

BPPV is a highly prevalent otoneurological pathology, characterized by brief and paroxysmal objective dizziness crises caused by head movements on the vertical and/or horizontal plane. The crises are repetitive and generally group together in a limited period of time (active phase) with a tendency to relapse after silent intervals of unpredictable duration (inactive phase) The peak incidence of this disorder affects subjects aged between 50 and 70 with a 2:1 ratio between females and males. This pathological picture is associated with a significant impact on healthcare spending and on the social aspect, since a percentage of 86% of patients suffering from this pathology interrupts ADLs (work and non-work). In recent years, diagnostics has been enriched by new procedures and accurate knowledge of the clinical manifestations of BPPV, as well as the acquisition of all new information in the context of the diagnostic process and therapeutic proposals, are fundamental for the optimal recovery of the patient's autonomy and also for savings in terms of time and costs.

Acute vestibular syndrome (AVS) is a clinical condition characterized by the sudden onset of vertigo, nausea, vomiting, and gait instability, often accompanied by nystagmus and head motion intolerance. AVS represents a frequent and challenging presentation in emergency and neurological settings, where timely differentiation between peripheral and central causes is critical to prevent life-threatening complications, particularly posterior circulation strokes.

This presentation aims to provide an updated overview of AVS, integrating recent advances in diagnostic strategies, risk stratification, and therapeutic approaches. We will focus on the utility of the HINTS (Head Impulse, Nystagmus, Test of Skew) examination as a bedside tool for distinguishing central from peripheral etiologies, emphasizing its sensitivity and specificity compared with early imaging. In addition, recent developments in vestibular function testing, including video head impulse tests and vestibular-evoked myogenic potentials, will be discussed as adjunctive tools for rapid and accurate assessment.

The congress session will also highlight evidence-based management strategies, covering pharmacological interventions for symptom control, vestibular rehabilitation techniques, and current recommendations for anticoagulation or thrombolytic therapy in cases of ischemic stroke. Case studies illustrating diagnostic challenges and treatment outcomes will be incorporated to bridge theory with clinical practice.

By addressing the spectrum of AVS from pathophysiology to bedside evaluation and therapeutic management, this presentation seeks to enhance clinician awareness, improve early recognition of central causes, and optimize patient outcomes. The session is designed for neurologists, emergency physicians, otolaryngologists, and allied healthcare professionals involved in acute care, fostering interdisciplinary dialogue on the latest evidence and best practices in AVS management.