Avaliação da função vestibular em indivíduos com perda auditiva de um serviço de saúde auditiva

Abstract

Purpose: To investigate the prevalence of dizziness complaints and vestibular findings in individuals with hearing loss and to compare the results of the non-instrumented evaluation with the video head impulse test (v-HIT), in addition to distinguishing the findings between individuals with and without dizziness complaints. Methodology: Observational, cross-sectional and analytical study, with 422 participants with hearing loss with the objective of calculating the prevalence of dizziness. Of these, 59 individuals underwent vestibular evaluation and were divided into two groups: G1 (with dizziness) and G2 (without dizziness). For the evaluation, instruments such as otoneurological anamnesis, Hearing Handicap Inventory for Adults (HHIA), Hearing Handicap Inventory for the Elderly – Screening (HHIE-S), Brazilian version of Dizziness Handicap Inventory (DHI), Visual Analogue Scale (VAS), Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), Subjective Visual Vertical (VVS), Head Shaking Test (HST), vibration-induced nystagmus test, clinical Head Impulse Test (HITc) and Video Head Impulse Test (v-HIT) were used. Statistical analysis included descriptive and bivariate tests. Categorical variables were expressed as frequencies and proportions; for associations, the Chi-square test (p < 0.05) was used. Quantitative variables were described by mean, median, standard deviation, quartiles, minimum and maximum values. Correlations were verified by Spearman's coefficient. Results: The prevalence of dizziness complaints was 21.3%. Of the 59 individuals evaluated, 71.2% were women, and 61% were 60 years or older. Complaints of tinnitus (88.1%) and discomfort with loud sounds (66.1%) were more common among those who reported dizziness (p=0.008 and p=0.049). The use of antivertigo drugs and central depressants was more frequent in this group (p=0.031). The predominant hearing loss was sensorineural, moderate and bilateral. Among the 33 individuals evaluated with v-HIT, 17 (51.5%) had normal vestibular function and 16 (48.5%) had peripheral vestibular dysfunction, predominant in the group with dizziness. However, the difference between the groups was not statistically significant (p=0.224). The clinical head impulse test (cHIT) showed a significant difference between the groups (p=0.047). There was a significant association between the v-HIT results and the perception of Subjective Visual Vertical (SVV) (p=0.008) and with HITc (p=0.002). Conclusion: The prevalence of dizziness (21.3%) highlights the importance of vestibular investigation in people with hearing loss. Vestibular dysfunction can occur with or without symptoms in this population. Non-instrumented tests are useful in the evaluation of dizziness both as a complement to tests with equipment and as an alternative in settings with limited resources.