The Role of an Inciting Event Causing Vertigo
LK is a 48-year-old female referred to otolaryngology with right-sided hearing loss, otalgia, and vertigo that began abruptly 5 months ago while she was scuba diving. At the time of the dive, LK was recovering from an upper respiratory tract infection (URI) and had significant difficulty auto-insufflating (using the Valsalva maneuver to equalize while diving). In addition to her symptoms, which began during the dive, she noticed increased autophony (hearing one’s own voice abnormally loud) after the dive. At the time of presentation to the clinic, LK’s primary complaint was autophony. The otalgia and vertigo appeared to have resolved. Her physical examination was normal with no evidence of middle ear fluid or a nasopharyngeal mass. An audiologic evaluation was recommended to further investigate LK’s symptoms.