BACKGROUND: To compare symptom burden, functional impact, emotional well-being, and health-related quality of life (HRQoL) between patients with chronic unilateral vestibular hypofunction (UVH) and bilateral vestibulopathy (BVP).

METHODS: This cross-sectional study included 100 patients with chronic UVH and 148 patients with BVP from a tertiary referral center. Symptom burden and functional impact were assessed using the Bilateral Vestibulopathy Questionnaire, Dizziness Handicap Inventory, and Oscillopsia Severity Questionnaire (OSQ). Emotional well-being was evaluated with the Hospital Anxiety and Depression Scale, and HRQoL with the EuroQol 5-Dimension 5-Level and Health Utility Index Mark 3. Total scores were compared across groups. Standardized mean differences (SMDs) were calculated to quantify the differences across all patient-reported outcome measures.

RESULTS: Bilateral vestibulopathy patients reported significantly greater symptom burden and functional limitations than chronic UVH patients (P < .05). No significant group differences were found in emotional well-being or generic HRQoL. Both patient groups showed significantly worse outcomes than healthy controls across most domains (P < .05). Standardized mean difference analysis showed that when effect sizes between groups were large or moderate, the differences were statistically significant. Conversely, when effect sizes were very low or small, there were no statistically significant differences (except for the OSQ, which remained significant despite a small effect size).

CONCLUSION: Chronic UVH and BVP are associated with significantly reduced QoL. Bilateral vestibulopathy patients report a greater symptom burden and functional limitations compared to patients with chronic UVH. These findings demonstrate the need for tailored assessments and targeted rehabilitation strategies for vestibular patients.