Introduction: With recent advancements in vestibular assessments, new ancillary tests can assist clinicians to better understand underlying cause of a balance problem. The recently established specialized vestibular clinic in Sultan Ahmad Shah Medical Centre @IIUM is equipped with these tests. This study aimed to determine the prevalence of the different diagnoses of balance disorders in a specialized vestibular clinic in Kuantan, Malaysia. Materials and Methods: This is a retrospective review of 121 walk-in patients over an 18-month period at a specialized Vestibular Clinic in Sultan Ahmad Shah Medical Centre @IIUM. The variables analysed in this review include the age, gender, ethnicity, diagnoses, and total number of visits before diagnoses were achieved. Results: Meticulous history taking, focused otorhinolaryngological examination and detailed vestibular assessment through the specialized vestibular clinic helped us in reaching a conclusive diagnosis. The most common cause of balance disorders in our review was Benign Paroxysmal Positional Vertigo (BPPV), constituting 41.3% of the cases. Among the canals, the posterior canal is the most affected  (70%) and is usually treated with Epley manoeuvre. Other common diagnoses   include Vestibular Migraine, Meniere’s Disease and Vestibular Neuritis. Conclusion: Vestibular clinics play a vital role in helping to pinpoint the accurate diagnosis of patients with balance disorders.

Background Nasopharyngeal tuberculosis constitutes 1% of the head and neck manifestation of extra-pulmonary tuberculosis. The rarity of the disease along with its non-specific presentation may pose a challenge in diagnosis. Case presentation We present a case of a 33-year-old patient who presented with a gradual onset of unilateral hearing loss. Endoscopic examination revealed leukoplakic lesions over the bilateral torus tubarius with audiological assessment revealing a mixed hearing loss in the left ear. Patient completed a 6-month course of anti-tuberculous therapy with a complete resolution of nasopharyngeal lesions and hearing loss. Conclusion We hypothesize that tuberculosis of the nasopharynx may not only lead to impaired middle ear ventilation but also damage to the ossicular chain and inner ear structures.