There is little information in the current literature about the management of dizziness in Primary Care (General Practice). An attempt was made to evaluate this by carrying out a postal survey of General Practitioners' (GPs) treatment methods in four Health Authorities in England and Wales. The survey revealed that eight out of every 1000 individuals are likely to consult their GP on account of dizziness in a 12-month period. The symptom is most common in the 60-80 years' age group, with 'labyrinthitis' being the commonest diagnosis. In the majority of cases (74.9 per cent) there was an improvement in the symptoms and only 13 per cent were referred to a specialist clinic. The survey also highlighted the need for additional resources to improve the management of these patients.

There have been several studies that have demonstrated a link between the hearing loss of subjects and tinnitus. However, there has been no systematic evaluation of the link between perceived tinnitus distress and an underlying hearing loss. The purpose of the current study is to explore this association, and ascertain whether a subject's hearing loss contributes to the handicap caused by tinnitus. A group of 96 adults were evaluated with Pure Tone Audiometry and a questionnaire that included the Tinnitus Handicap Inventory (THI). In 58% of the subjects, the side of the unilateral or worse tinnitus corresponded with the ear with poorer hearing thresholds. A subset of the THI, the Two Question Mean (TQM) that was related to questions with regard to communication, correlated significantly with the hearing thresholds in the better hearing ear ( P < 0.01). There was also a significant correlation between the THI and TQM scores ( P < 0.01). These results suggested that in tinnitus subjects with impaired hearing, the underlying hearing loss may be a significant factor in the perceived distress.

No abstract

The 18q-syndrome is associated with hearing impairment in 50-80 per cent of cases. The hearing loss may be sensorineural or conductive. A high proportion of cases are associated with narrow or stenosed external auditory canals. This may be a useful clinical pointer to the syndrome. Two cases with impaired hearing are presented in this paper including one case with complex external ear and middle ear malformations. The clinical and audiological features in each case are described.