Ear, Nose, and Throat Disorders

Peripheral Vertigo

Vertigo might impact the ability of the LEO to safely and effectively perform work at unprotected heights, operate an emergency vehicle, perform pursuit, apprehension or restraint and the use of their weapon.

Vestibular Neuronitis/Labyrinthitis

Vestibular neuronitis – symptoms typically include rapid onset of constant, severe vertigo, nausea, and vomiting. In pure VN, there is an absence of tinnitus and hearing loss.

The LEO can return to full duty when:

• Symptoms have resolved
• Off all anti-vertigo medications
• No signs of any persistent vertigo
  • normal Romberg
  • no nystagmus
• If there is persistent vertigo, ENT evaluation and/or electronystagmography may be considered to assist with the return-to-duty decision

Labyrinthitis – symptoms include those of VN, with the addition of tinnitus and/or hearing loss.

The LEO can return to full duty when:

• Symptoms have resolved
• Off all anti-vertigo medications
• No signs of any persistent vertigo
  • normal Romberg
  • no nystagmus
• If there is persistent vertigo, ENT evaluation and/or electronystagmography may be considered to assist with the return-to-duty decision

Benign Paroxsymal Positional Vertigo (BPPV)

The LEO can return to full duty when:

• Symptoms have resolved
• Off all anti-vertigo medications
• No signs of any persistent vertigo
  • normal Romberg
  • negative Dix-Hallpike and/or supine roll test

Ménière’s Disease

Ménière’s disease should be considered a disqualifying condition for LEOs, due to the severity and unpredictable nature of the attacks of vertigo, which can cause sudden incapacitation without warning. The condition is typically chronic, progressive, and unlikely to resolve.

Medical treatment can be helpful in controlling symptoms during an attack of Ménière’s disease, however, treatment generally does not eliminate the condition. Treatment options may also cause debilitating symptoms, such as sedation with medications, or hearing loss with invasive treatment.