Importance Bilateral vestibular deficiency (BVD) causes chronic imbalance, unsteady vision, and greatly increases the risk of falls; however, its effects on quality of life (QOL) and economic impact are not well defined. Objective Quantify disease-specific and health-related quality of life, health care utilization and economic impact suffered by individuals with BVD in comparison to those with unilateral vestibular deficiency (UVD) Design Cross-sectional survey study of BVD, UVD, and healthy individuals Setting Academic medical center Participants Fifteen BVD, 22 UVD and 23 healthy individuals. Vestibular dysfunction was diagnosed by caloric nystagmography Intervention Survey questionnaire Main Outcomes and Measures Health status was measured using the Dizziness Handicap Index (DHI) and Health Utility Index Mark 3 (HUI3). Economic burden was estimated using participant responses to questions on disease-specific health care utilization and lost productivity. Results In comparison to UVD and normal controls, BVD patients had significantly worse DHI and HUI3 scores. Multivariate regression analysis showed UVD, BVD, increasing number of dizziness-related emergency department (ED) visits, and increasing dizziness-related work-place absenteeism were associated with worse HUI3 scores. BVD and UVD patients incurred annual economic burdens of $13,019 and $3,531 per patient, respectively. Conclusions and Relevance BVD significantly decreases quality of life and imposes substantial economic burdens on individuals and society. These results underscore the limits of adaptation and compensation in BVD. Furthermore, they quantify the potential benefits of prosthetic restoration of vestibular function both to these individuals and to society.

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Many vaccine-related adverse events are associated with otolaryngologic manifestations. In particular, the incidence of sudden sensorineural hearing loss (SSNHL) was examined after influenza vaccination in a large-scale study that demonstrated no association between vaccination and the rate of SSNHL. 1 Anecdotal reports are rapidly emerging from the otolaryngology community of SSNHL occurring after inoculation by SARS-CoV-2 vaccines that are currently in use in the US under US Food and Drug Administration Emergency Use Authorizations. Recognizing the important public health implications of any association between COVID-19 vaccination and SSNHL, and motivated by patients who presented to our practice (Johns Hopkins University; Baltimore, Maryland) with audiometrically confirmed unilateral SSNHL that occurred within 24 hours of COVID-19 vaccination, we sought to (1) estimate the national incidence of SSNHL after COVID-19 vaccination using data from the Vaccine Adverse Events Reporting System (VAERS) maintained by the US Centers for Disease Control and Prevention (CDC) and (2) compare this with the expected incidence of SSNHL in the wider population. 2