What happened?
A 59-year-old man was referred to outpatient physiotherapy for episodes of spinning dizziness and was initially considered to have a peripheral vestibular disorder. His history also included ear symptoms and chronic rhinosinusitis, demonstrating why a broad clinical history matters when symptoms do not fit a simple pattern.
Clinical findings
- Dizziness episodes lasted for hours and lacked a consistent positional trigger.
- The patient also reported aural fullness, pressure, tinnitus and nausea; medical investigations identified chronic rhinosinusitis with nasal polyposis and sinus disease.
- Vestibular-ocular reflex exercises were prescribed, but travel limited adherence.
Rehabilitation described in the report
- The physiotherapy clinician evaluated vestibular signs and prescribed a home vestibular exercise programme.
- The patient subsequently underwent ENT-directed medical and surgical management for chronic rhinosinusitis; this was a multidisciplinary diagnostic and management pathway, not a physiotherapy-only intervention.
Reported outcomes
- At follow-up, the patient reported that dizziness and vertigo-like symptoms had resolved after sinus-related treatment.
- Because he had not consistently performed the prescribed exercises, the improvement should not be attributed to the exercise programme.
Clinical lessons to consider
- Dizziness lasting hours without a clear positional trigger deserves careful differential diagnosis rather than automatic treatment as BPPV.
- Ask about hearing, tinnitus, aural pressure, sinus symptoms, medication and medical history; refer when the presentation suggests another cause.
- Document what treatment was actually received before attributing improvement to physiotherapy.
Limitations — what this case cannot tell us
- One case cannot establish chronic rhinosinusitis as a common cause of dizziness or prove causation.
- Symptoms resolved after combined medical/surgical management; the independent contribution of each factor is uncertain.
Original source
Shellie Zsoldos, Chia-Cheng Lin. “Resolution of Dizziness Following Treatment for Chronic Rhinosinusitis: A Case Report From Physical Therapy Outpatient Setting.” Case Reports in Otolaryngology, 2025. DOI: 10.1155/crot/6175181
View the original publicationThis page is an independently written educational summary, not a reproduction of the full paper. Check the original article for complete methods, outcome tables, references and licensing.