めまいを主訴とする耳鼻咽喉科初診患者の外来診療実態調査の試み

One of the most typical symptoms of patients encountered in outpatient otorhinolaryngology clinics is dizziness. We conducted a study on the real-world outpatient practices for first-time otorhinolaryngology patients presenting with the chief complaint of dizziness, in order to improve the clinical practices and support the education of otorhinolaryngology majors. The subjects of the study were a total of 254 patients who first visited the outpatient otorhinolaryngology departments of one of the eight participant hospitals between August 2018 and July 2019 with the chief complaint of dizziness or related symptoms, such as rotatory vertigo, disorientation, or a floating sensation. Data of the outpatients at their first visit were extracted by a retrospective chart review and using the Dizziness Checklist that was created prior to the data collection. The patients ranged in age from 6 to 92 years, with a mean age of 61 years. The ratio of men to women was approximately 2:3. Of the patients, 43% had another outpatient otorhinolaryngology visit, while the remaining patients visited only once. The likelihood of a second outpatient visit was significantly higher in patients with nystagmus. The rates of performance of the equilibrium function tests of stabilometry, VOR (to manual rotation stimulation of the examination chair), caloric test, vHIT, and VEMP were 45.7%, 30.7%, 5.1%, 4.7%, and 2.0%, respectively. In contrast, the rates of performance of nystagmus testing and conventional pure tone audiometry were 98.4% and 93.7%, respectively. To determine the relationship between the presence of dizziness consultant physicians certified by the Japan Society For Equilibrium Research and the rates of performance of equilibrium function tests, we compared the rates in cases that visited hospitals with (151 cases) and without (103 cases) dizziness consultant physicians; the results revealed higher rates of performance of equilibrium function tests in the hospitals with dizziness consultant physicians.