Impact of otolith dysfunction on postural stability and quality of life: A prospective, case-control study

BackgroundVestibular evoked myogenic potentials (VEMPs) are widely used to assess the otolith organs; however, the clinical significance of otolith organ dysfunction is unclear.ObjectiveThe primary purpose was to determine the functional consequences of otolith dysfunction on postural stability and quality of life in U.S. Veterans.MethodsA prospective case-control design was used, and 124 participants (21-84 years) were grouped based on comprehensive vestibular testing. Caloric and vertical canal video head impulse testing were used to determine semicircular canal function. Cervical and ocular VEMP testing determined otolith organ function. Three vestibular site-of-lesion groups (Otolith Only, Otolith + Canal, and Canal Only) and two control groups (Dizzy Control and Non-Dizzy Control) completed measures of quality of life and multiple measures of postural control.ResultsANCOVAs indicated significant group differences for measures of quality of life and postural stability. All vestibular groups (Otolith Only, Otolith + Canal, and Canal Only) reported significantly worse quality of life than Non-Dizzy Controls. The Otolith + Canal group performed significantly worse than the Otolith Only group and both control groups on the functional gait assessment and preferred gait speed.ConclusionsSimilar to isolated semicircular canal dysfunction, isolated otolith dysfunction may negatively impact quality of life, and in conjunction with semicircular canal dysfunction, may also negatively impact postural stability.