Audiological and Vestibular Findings in an Adult with Tinnitus and Dizziness: A Case Report

Background: Tinnitus is a phantom auditory perception that can significantly affect cognitive, emotional, and psychosocial well-being. It is often associated with dizziness and vestibular dysfunction, contributing to a reduced quality of life. Despite extensive research, the exact pathophysiology remains unclear, making diagnosis and management challenging. Materials and methods: A 49 years old male locomotive pilot reported of occupational noise exposure with right-sided tinnitus, dizziness and imbalance. Comprehensive audiological and vestibular assessment included pure tone audiometry, speech audiometry (SRT and WRS) and immittance audiometry followed by vestibular subjective tests (Romberg and Fukuda Step Test) and objective assessment (VNG, cVEMP and oVEMP). Results and discussion: Audiological findings revealed moderately severe sensorineural hearing loss in the right ear with reduced speech discrimination scores and no acoustic reflexes. Vestibular subjective examination showed unilateral vestibular weakness of the right side. Videonystagmography demonstrated left beating nystagmus after shaking of the head that implied of vestibuloparesis of the right side. Cervical and ocular Vestibular Evoked Myogenic Potentials (cVEMP and oVEMP) were absent on the right indicating an associated existence of vestibular dysfunction in sacculo-colic and utriculo-ocular pathways. Self-report questionnaires (THI and DHI) showed mild handicap (tinnitus and dizziness) with modest quality of life impact. Conclusion: A holistic and integrated audiological and vestibular evaluation is of paramount importance for diagnosing adults with auditory and vestibular co-morbidity. Early intervention and prevention measures, such as noise protection and balance rehabilitation, are crucial for prevention of the long-term consequences. Key words: Tinnitus, vestibular dysfunction, VEMP, noise-induced hearing loss.