Florida Combined Otolaryngology Meeting 2024 – The Cost of Untreated Vestibular Conditions: the Role of Otolaryngology & Rehabilitation

Otolaryngology has become the most well-recognized medical specialty for referral for patients with disorders affecting equilibrium, specifically acute, chronic dizziness, vertigo, and history of imbalance including falls. An investigation of referrals by Primary Care physicians (PCP) reported as high as 24% of their patients were referred to otolaryngology for dizziness consultation. Historically however, many otolaryngology departments and practices, do not offer comprehensive in-house neurodiagnostic services beyond audiology. Hearing tests alone, rarely provides the genesis or best triage and management strategies for the equilibrium disordered patient. Likewise, availability of trained and experienced physiotherapists in vestibular rehabilitation (VRT) may be limited. This presentation will provide attendees with an overview of the economic burden placed on the health care system and the cost-savings and reduction of perceived disability should patients be referred to otolaryngology practices that provide neurodiagnostic vestibular-balance testing. This testing should provide a clinical pathway to efficient and efficacious patient-centered rehabilitation therapies. Alipour et al., reported in a meta-analysis of 456 articles of which 16 were included, that despite success in reducing falls, they were not necessarily cost-effective. We will suggest that if elevated fall-risk individuals can be properly evaluated within ENT practices to identify their specific functional impairments for which diagnosis-based strategy can be applied in a patient-centered therapy, a more cost-effective approach can be implemented rather than a one-size fits all approach to fall risk management. At the conclusion of the session, attendees will be able to: 1. Identify indicators for elevated fall-risk individuals with both otologic and non-otologic conditions. 2. Discuss in-office neurodiagnostic vestibular protocols with high diagnostic efficiencies and predictive values. 3. Describe appropriate rehabilitation triage for patients with and without a vestibular component to their imbalance.