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.

A better understanding of cortical neuroplasticity accompanying hearing loss may allow us to improve intervention and rehabilitation for patients with hearing loss.  compensation for the deleterious effects of hearing loss include recruitment of alternative brain networks during cortical processing. Our experiments suggest that early stage, mild-moderate, age-related hearing loss ranging results in significant changes in neural resource allocation, reflecting patterns of cross-modal compensation from the visual and somatosensory modalities, increased listening effort, and decreased cognitive spare capacity. Adults with untreated age-related hearing loss also show evidence of cognitive decline. Treatment with hearing aids reverse cross-modal recruitment of auditory cortex over the course of 6 months, coinciding with gains in auditory speech perception abilities, social-emotional processing and significant improvements in cognitive performance as measured by clinical tests of neurocognition. New data on results of neurocognitive changes with over-the-counter hearing aids will be discussed.