Remote technologies in the management of patients with vestibular pathology

Guseva A.L.; Demkina A.E.; Sudarev P.A.; Tishkina A.V.; Udagova Z.A.; Derbeneva M.L.

doi:https://doi.org/10.17116/otorino20259003153

OBJECTIVE

To assess the applicability of modern remote technologies for diagnosis, treatment and monitoring patients with dizziness.

We conducted a scoping review by searching eLibrary, PubMed, Scopus databases for the use of various devices and applications to diagnose and treat patients with vertigo and dizziness, based on the history taking, assessment of subjective symptoms, evaluation of the of vestibular test results, remote diagnosis and treatment of vestibular disorders. The advantages of telemedicine at different communication levels as well as limitations preventing its full and widespread use are discussed. The potential promising trends in remote technologies for clinical practice are highlighted.

Keywords:

telemedicine

remote technologies

dizziness

vertigo

vestibular disorders

telehealth

Authors:

Guseva A.L.

Pirogov Russian National Research Medical University;
Pirogov City Clinical Hospital No. 1

SPIN RSCI: 4417-2650
Scopus AuthorID: 56605413000
ORCID: 0000-0002-7988-4229

Demkina A.E.

Innovative Academy of Professional Development “Dokstarklab”

ORCID: 0000-0001-8004-9725

Sudarev P.A.

Sverzhevsky Research Clinical Institute of Otorhinolaryngology

ORCID: 0000-0001-9085-9879

Tishkina A.V.

Pirogov Russian National Research Medical University

ORCID: 0009-0007-2804-3685

Udagova Z.A.

Pirogov Russian National Research Medical University;
Pirogov City Clinical Hospital No. 1

ORCID: 0009-0005-4124-863X

Derbeneva M.L.

Pirogov City Clinical Hospital No. 1

ORCID: 0000-0002-8184-7312

Received:

07.11.2024

Accepted:

30.01.2025

Close metadata

References:

Murdin L, Schilder AGM. Epidemiology of balance symptoms and disorders in the community: a systematic review. Otology and Neurotology. 2015;36(3):387-392. https://doi.org/10.1097/MAO.0000000000000691
López-Gentili LI, Kremenchutzky M, Salgado P. [A statistical analysis of 1300 patients with dizziness-vertigo. Its most frequent causes]. Revue Neurologique. 2003;36(5):417-420. (In Spanish).
Bisdorff A, Von Brevern M, Lempert T, Newman-Toker DE. Classification of vestibular symptoms: towards an international classification of vestibular disorders. Journal of Vestibular Research. 2009;19(1-2):1-13. https://doi.org/10.3233/VES-2009-0343
Newman-Toker DE. Missed stroke in acute vertigo and dizziness: It is time for action, not debate. Annals of Neurology. 2016;79(1):27-31. https://doi.org/10.1002/ana.24532
Jaffe DH, Lee L, Huynh S, Haskell TP. Health Inequalities in the Use of Telehealth in the United States in the Lens of COVID-19. Population Health Management. 2020;23(5):368-377. https://doi.org/10.1089/pop.2020.0186
Aksenova EI, Gorbatov SYu. Tsifrovizatsiya zdravookhraneniya: opyt i primery transformatsii v sistemakh zdravookhraneniya v mire. M.: GBU «NIIOZMM DZM»; 2020. (In Russ.). Accessed February 17, 2025 https://niioz.ru/doc/Cifrovizaciya-zdravoohraneniya.pdf
Barreto RG, Yacovino DA, Cherchi M, Nader SN, Teixeira LJ, Silva DAD, Verdecchia DH. The Role of the Smartphone in the Diagnosis of Vestibular Hypofunction: A Clinical Strategy for Teleconsultation during the COVID-19 Pandemic and Beyond. International Archives of Otorhinolaryngology. 2021;25(4):602-609. https://doi.org/10.1055/s-0041-1736340
Nomura A, Tanigawa T, Muto T, Oga T, Fukushima Y, Kiyosue A, Miyazaki M, Hida E, Satake K. Clinical Efficacy of Telemedicine Compared to Face-to-Face Clinic Visits for Smoking Cessation: Multicenter Open-Label Randomized Controlled Noninferiority Trial. Journal of Medical Internet Research. 2019;21(4):e13520. https://doi.org/10.2196/13520
Jaensson M, Dahlberg K, Eriksson M, Nilsson U. Evaluation of postoperative recovery in day surgery patients using a mobile phone application: a multicentre randomized trial. British Journal of Anaesthesia. 2017;119(5):1030-1038. https://doi.org/10.1093/bja/aex331
Aida A, Svensson T, Svensson AK, Urushiyama H, Okushin K, Oguri G, Kubota N, Koike K, Nangaku M, Kadowaki T, Yamauchi T, Chung UI. Using mHealth to Provide Mobile App Users With Visualization of Health Checkup Data and Educational Videos on Lifestyle-Related Diseases: Methodological Framework for Content Development. JMIR Mhealth Uhealth. 2020;8(10):e20982. https://doi.org/10.2196/20982
Ukaz Prezidenta Rossijskoj Federatsii ot 6 iyunya 2019 g. №254 «O Strategii razvitiya zdravookhraneniya v Rossijskoj Federatsii na period do 2025 goda». (In Russ.). Accessed February 17, 2025. https://roszdravnadzor.gov.ru/documents/60367
Shaderkin IA. Remote monitoring of human health and the environment: opportunities and limitations. Rossijskij zhurnal telemeditsiny i elektronnogo zdravookhraneniya. 2022;8(3):45-54. (In Russ.). https://doi.org/10.29188/2712-9217-2022-8-3-45-54
Wolf SR, Christ P, Haid CT. “Telemetric” electronystagmography: a new method for examination of nystagmus outside the clinic. Acta Oto-Laryngologica Supplementum. 1991;481:374-81. https://doi.org/10.3109/00016489109131426
Viirre E. Vestibular telemedicine and rehabilitation. Applications for virtual reality. Studies in Health Technology and Informatics. 1996;29:299-305.
Viirre E, Warner D, Balch D, Nelson JR. Remote medical consultation for vestibular disorders: technological solutions and case report. Telemedicine Journal. 1997;3(1):53-58. https://doi.org/10.1089/tmj.1.1997.3.53
Martin EC, Verkaik R, Stultiens JJA, van de Berg MR, Janssen AML, Leue C, Delespaul P, Peeters F, Widdershoven J, Erdkamp A, van de Weijer SCF, Blom H, Zwergal A, Grill E, Guinand N, Perez-Fornos A, Tse D, van de Berg R. The DizzyQuest: relation between self-reported hearing loss, tinnitus and objective hearing thresholds in patients with Meniere’s disease. Journal of Neurology. 2022;269(10):5239-5248. https://doi.org/10.1007/s00415-021-10909-8
Zwergal A, Brandt T, Magnusson M, Kennard C. DIZZYNET — a European network initiative for vertigo and balance research: visions and aims. Journal of Neurology. 2016;263(Suppl 1):S2-S9. https://doi.org/10.1007/s00415-015-7912-3
Kıroğlu M, Dağkıran M. The Role of Mobile Phone Camera Recordings in the Diagnosis of Meniere’s Disease and Pathophysiological Implications. The Journal of International Advanced Otology. 2020;16(1):18-23. https://doi.org/10.5152/iao.2019.6605
Gold D, Tourkevich R, Shemesh A, Brune A, Choi W, Peterson S, Bosely J, Maliszewski B, Fanai M, Otero-Milan J, Roberts D, Zee D, Newman-Toker D. A novel tele-dizzy consultation program in the emergency department using portable video-oculography to improve peripheral vestibular and stroke diagnosis. Neurology. 2019;92(15 Supplement):S28.002. https://doi.org/10.1212/WNL.92.15_supplement.S28.002
Shah MU, Lotterman S, Roberts D, Eisen M. Smartphone telemedical emergency department consults for screening of nonacute dizziness. Laryngoscope. 2019;129(2):466-469. https://doi.org/10.1002/lary.27424
Parker TM, Farrell N, Otero-Millan J, Kheradmand A, McClenney A, Newman-Toker DE. Proof of Concept for an “eyePhone” App to Measure Video Head Impulses. Digital Biomarkers. 2020;5(1):1-8. https://doi.org/10.1159/000511287
Brodsky JR, Cusick BA, Kawai K, Kenna M, Zhou G. Peripheral vestibular loss detected in pediatric patients using a smartphone-based test of the subjective visual vertical. International Journal of Pediatric Otorhinolaryngology. 2015;79(12):2094-2098. https://doi.org/10.1016/j.ijporl.2015.09.020
Riera-Tur L, Caballero-Garcia A, Martin-Mateos AJ, Lechuga-Sancho AM. Efficacy of the subjective visual vertical test performed using a mobile application to detect vestibular pathology. Journal of Vestibular Research. 2022;32(1):21-27. https://doi.org/10.3233/VES-201526
Wengier A, Ungar OJ, Handzel O, Cavel O, Oron Y. Subjective Visual Vertical Evaluation by a Smartphone-based Test-Taking the Phone Out of the Bucket. Otology and Neurotology. 2021;42(3):455-460. https://doi.org/10.1097/MAO.0000000000002944
Phillips JS, Newman JL, FitzGerald JE, Cox SJ. Implications of vestibular telemetry for the management of Ménière’s disease — our experience with three adults. Clinical Otolaryngology. 2020;46(2):425-429. https://doi.org/10.1111/coa.13676
van Bonn SM, Behrendt SP, Pawar BL, Schraven SP, Mlynski R, Schuldt T. Smartphone-based nystagmus diagnostics: development of an innovative app for the targeted detection of vertigo. European Archives of Oto-Rhino-Laryngology. 2022;279(12):5565-5571. https://doi.org/10.1007/s00405-022-07385-9
Wagle N, Morkos J, Liu J, Reith H, Greenstein J, Gong K, Gangan I, Pakhomov D, Hira S, Komogortsev OV, Newman-Toker DE, Winslow R, Zee DS, Otero-Millan J, Green KE. aEYE: A deep learning system for video nystagmus detection. Frontiers in Neurology. 2022;13:963968. https://doi.org/10.3389/fneur.2022.963968
Ippisch R, Jelusic A, Bertram J, Schniepp R, Wuehr M. mVEGAS — mobile smartphone-based spatiotemporal gait analysis in healthy and ataxic gait disorders. Gait and Posture. 2022;97:80-85. https://doi.org/10.1016/j.gaitpost.2022.07.256
Parker TM, Badihian S, Hassoon A, Saber Tehrani AS, Farrell N, Newman-Toker DE, Otero-Millan J. Eye and Head Movement Recordings Using Smartphones for Telemedicine Applications: Measurements of Accuracy and Precision. Frontiers in Neurology. 2022;13:789581. https://doi.org/10.3389/fneur.2022.789581
Friedrich MU, Schneider E, Buerklein M, Taeger J, Hartig J, Volkmann J, Peach R, Zeller D. Smartphone video nystagmography using convolutional neural networks: ConVNG. Journal of Neurology. 2023;270(5):2518-2530. https://doi.org/10.1007/s00415-022-11493-1
Bamiou DE, Kikidis D, Bibas T, Koohi N, Macdonald N, Maurer C, Wuyts FL, Ihtijarevic B, Celis L, Mucci V, Maes L, Van Rompaey V, Van de Heyning P, Nazareth I, Exarchos TP, Fotiadis D, Koutsouris D, Luxon LM. Diagnostic accuracy and usability of the EMBalance decision support system for vestibular disorders in primary care: proof of concept randomised controlled study results. Journal of Neurology. 2022;269(5):2584-2598. https://doi.org/10.1007/s00415-021-10829-7
Seim NB, Philips RHW, Matrka LA, Locklear B, Inman M, Moberly AC, Essig GF Jr. Developing a synchronous otolaryngology telemedicine Clinic: Prospective study to assess fidelity and diagnostic concordance. Laryngoscope. 2018;128(5):1068-1074. https://doi.org/10.1002/lary.26929
Kunelskay NL, Ivanova GE, Baybakova EV, Guseva AL, Parfenov VA, Zamergrad MV, Zaitseva OV, Melnikov OA, Shmonin AA, Maltseva MN. Vestibular rehabilitation for peripheral vestibular hypofunction: an interdisciplinary consensus. Russian Bulletin of Otorhinolaryngology. 2024;89(1):52-63. (In Russ.). https://doi.org/10.17116/otorino20248901152
Kunelskaya NL, Baibakova EV, Zaoeva ZO, Guseva AL, Chugunova MA, Manaenkova EA, Vinogradova MV. Rehabilitation in bilateral vestibulopathy: trends and perspectives. Russian Bulletin of Otorhinolaryngology. 2024;89(2):59-65. (In Russ.). https://doi.org/10.17116/otorino20248902159
Tabanfar R, Chan HHL, Lin V, Le T, Irish JC. Development and face validation of a Virtual Reality Epley Maneuver System (VREMS) for home Epley treatment of benign paroxysmal positional vertigo: A randomized, controlled trial. American Journal of Otolaryngology. 2018;39(2):184-191. https://doi.org/10.1016/j.amjoto.2017.11.006
Kanyılmaz T, Topuz O, Ardıç FN, Alkan H, Öztekin SNS, Topuz B, Ardıç F. Effectiveness of conventional versus virtual reality-based vestibular rehabilitation exercises in elderly patients with dizziness: a randomized controlled study with 6-month follow-up. Brazilian Journal of Otolaryngology 2022;88(Suppl 3):S41-S49. https://doi.org/10.1016/j.bjorl.2021.08.010
Lubetzky AV, Kelly J, Wang Z, Gospodarek M, Fu G, Sutera J, Hujsak BD. Contextual sensory integration training via head mounted display for individuals with vestibular disorders: a feasibility study. Disability and Rehabilitation. Assistive Technology. 2022;17(1):74-84. https://doi.org/10.1080/17483107.2020.1765419
van Vugt VA, van der Wouden JC, Essery R, Yardley L, Twisk JWR, van der Horst HE, Maarsingh OR. Internet based vestibular rehabilitation with and without physiotherapy support for adults aged 50 and older with a chronic vestibular syndrome in general practice: three armed randomised controlled trial. BMJ. 2019;367:l5922. https://doi.org/10.1136/bmj.l5922
Guerrero K, Umagat A, Barton M, Martinez A, Ho KY, Mann S, Hilgenkamp T. The effect of a telehealth exercise intervention on balance in adults with Down syndrome. Journal of Applied Research in Intellectual Disabilities: JARID. 2023;36(2):385-393. https://doi.org/10.1111/jar.13068
Namazova-Baranova LS, Suvorov RE, Smirnov IV, Molodchenkov AI, Antonova EV, Vishneva EA, Smirnov VI. Patient risk management based on remote health monitoring technologies: the state of the region and prospects. Vestnik Rossijskoj akademii meditsinskikh nauk. 2015;70(1):82-89. (In Russ.). https://doi.org/10.15690/vramn.v70i1.1235
Karpov OE, Sveshnikov AV, Vorobev AS. New methods of monitoring vital body functions in the era of telemedicine. Menedzher zdravookhraneniya. 2016;(8):54-66. (In Russ).
Janssen F, Awadallah M, Alhalabi A, Körber B, Lang R, Scibor M, Handschu R. Telemedicine in general neurology: use of audiovisual consultation for on call back-up service in an acute care hospital. Journal of Neurology. 2018; 265(4):880-884. https://doi.org/10.1007/s00415-018-8756-4
Young AS, Lechner C, Bradshaw AP, MacDougall HG, Black DA, Halmagyi GM, Welgampola MS. Capturing acute vertigo: A vestibular event monitor. Neurology. 2019;92(24):e2743-e2753. https://doi.org/10.1212/WNL.0000000000007644
Muller I, Kirby S, Yardley L. Understanding patient experiences of self-managing chronic dizziness: a qualitative study of booklet-based vestibular rehabilitation, with or without remote support. BMJ Open. 2015;5(5):e007680. https://doi.org/10.1136/bmjopen-2015-007680
Parfenov VA, Kulesh AA, Demin DA, Guseva AL, Vinogradov OI. Vestibular vertigo in stroke and vestibular neuronitis. S.S. Korsakov Journal of Neurology and Psychiatry. Special issues. 2021;121(12-2):41-49. (In Russ.). https://doi.org/10.17116/jnevro202112112241
Müller-Barna P, Hubert ND, Bergner C, Schütt-Becker N, Rambold H, Haberl RL, Hubert GJ. TeleVertigo: Diagnosing Stroke in Acute Dizziness: A Telemedicine-Supported Approach. Stroke. 2019;50(11):3293-3298. https://doi.org/10.1161/STROKEAHA.119.026505
Green KE, Pogson JM, Otero-Millan J, Gold DR, Tevzadze N, Saber Tehrani AS, Zee DS, Newman-Toker DE, Kheradmand A. Opinion and Special Articles: Remote Evaluation of Acute Vertigo. Neurology. 2021;97(9):459. https://doi.org/10.1212/wnl.0000000000012239
Vladzimirsky AV, Gusev AV, Sharova DE, Shulkin IM, Popov AA, Balashov MK, Omelyanskaya OV, Vasilyev YA. Health Information System Maturity Assessment Methodology. Vrach i informatsionnye tekhnologii. 2022;3:68-86. (In Russ.). https://doi.org/10.25881/18110193_2022_3_68
Vedekhina OYu. Experience in organizing cardiology services at the outpatient stage in rural areas. Klinicheskaya meditsina i farmakologiya. 2016;2(2):58-65. (In Russ.). https://doi.org/10.12737/20990