He subsequently proceeded to Guy's Hospital Medical School in London, UK. His studies focused on the olfactory mucosa of the mouse and the relevant histology work was included in the 35th Edition of Gray's Anatomy 1973, p. 1090. Whilst carrying out his studies in London, he also worked as a demonstrator at Guy's Hospital. He completed his PhD in 1972 and returned to Malta at the Anatomy Department where he was appointed Lecturer in Anatomy at the University of Malta.

Scientific papers on his further studies of the development of the olfactory mucosa in the mouse using light microscopy were published in the Journal of Anatomy (1975) 119, pp. 277–286 and other eminent scientific journals.

In 1979, he proceeded to Kuwait as Associate Professor in Anatomy and Consultant Geneticist where he served till 1984. He helped to set up the Cytogenetic Center as an Annexe to Al-Sabah Hospital in Kuwait and trained several young doctors in cytogenetic analysis. During this period, his work in anatomy included:

He returned to Malta in 1984 and was appointed Professor of Anatomy and Genetics at the University of Malta and served as Head of Department for various periods since 1991. He also served as Director to the Institute of Gerentology and helped to set up the University of the Third Age in 1991.

He was very active in researching various aspects of congenital malformations in Malta and published a number of related scientific papers. In 1984, he was instrumental in setting up the National Register of Congenital Anomalies.

From 2008 onwards, his studies focused mainly on fetuses with anomalies. He showed particular interest in telomeric causes of mental retardation and in Li-Fraumeni syndrome.

He was innovative in his approach to teaching and introduced what he called “critical thinking sessions” which were aimed at helping students to understand the relevance of the basic sciences to the clinical scenarios.

Prof. Alfred Cuschieri was a Member of the Royal Society of Medicine, Anatomical Society of Great Britain and Ireland, Clinical Genetics Society, and Skeletal Dysplasia Group for Teaching and Research. He was also Vice-President of the National Bio-Ethics Committee.

Prof. Alfred Cuschieri was a colleague who was held in high esteem by his peers. He was a gentleman as well as having a very gentle nature. He treated all and sundry with respect and showed care and understanding towards others. He also had a sense of humor and would drop a little joke during a lecture to stimulate students' interest.

Though he became terminally ill in 2009, he continued to spend time on campus till his health failed him. Sadly, he passed away on the 25th of January 2010. He left to mourn his loss, his wife Monica nee Misud, whom he married in 1969, his two daughters and five grandchildren, besides numerous friends and colleagues.

Of all the symptoms of otological/neurotological diseases, vertigo can be one of the most incapacitating of symptoms. Vertigo almost always arises from the pars posterior (the vestibular portion of the inner ear) and rarely from central or intracranial causes. Vertigo, often associated with nausea and vomiting, can be defined as any sensation of motion, characteristically a spinning sensation, external or internal (perceived to be within the patients head).

It should be noted, however, that peripheral vestibular diseases such as Ménière's disease can also produce symptoms of disequilibrium, a sensation of being off-balance, visually induced vertigo or the so-called shopping center nystagmus, motion-related or positional vertigo which can be confused with benign positional vertigo, and episodes of falling. Vertigo is usually accompanied by symptoms of the cochlea (pars inferior, anterior labyrinth) such as sensorineural hearing loss, which can fluctuate and become progressive, pressure or tinnitus or an inability to tolerate loudness (recruitment), any one of which can be the patients chief complaint. Often, vestibular symptoms from the posterior labyrinth appear dominant over cochlear symptoms, although less often cochlear symptoms can also be of greater difficulty to the patient.

I am pleased that the editors have included articles on Epidemiology of Dizziness (Chapter 3). For many years, I have observed Ménière's disease to be far more prevalent in the northern cities as compared to southern cities, in all the countries of the world. I hope that controlled demographic studies will assess this observation. Moreover, for decades, I have described Ménière's disease as having a genetic basis, or that the etiology of Ménière's disease is “multifactorial inheritance” (1985). I am also pleased that a chapter on “Atypical Ménière's Disease” (Chapter 8) is included, since many patients suffer from atypical types of Ménière's disease with lesser symptoms, and not every patient has to have fully manifest Ménière's disease.

Since vertigo and vestibular symptoms are such common and major problems internationally, I congratulate Dr Francesco Dispenza and Dr Alessandro De Stefano for organizing, editing, and authoring this compilation of authors to shed light on this most serious symptom of vertigo and vestibular diseases that beset mankind.

We remember that when we were young students at Medical Schools, some difficult to understand vestibular disorders were present, probably due to the compartmentalization of the notions in several disciplines, never summarized in a single theme.

Even today, vertigo is a common and frustrating symptom told by more than a few patients to all physicians. Effectively, vertigo may be the first expression of several diseases, including life-threatening conditions.

The difficult to analyze vertigo not only starts from an etiologic point of view but also from a terminological one.

What is vertigo? Strictly speaking, vertigo is an “illusory perception of motion,” but patients often refer ambiguously to vertigo, dizziness, giddiness and disequilibrium or imbalance.

In addition, many specialists could be consulted by a dizzy patient: Otolaryngologists, Neurologists, Family Physicians, Emergency-Care Physicians and Ophthalmologists; and this variability may lead to unnecessary diagnostic tests with delay in the diagnosis and management.

For this reason, we have thought of a book in which the various features of vertigo were treated by some of the most famous scientists worldwide, specialized in treatment of balance disorders. Not only Otologists but also Neurologists, Epidemiologists, Physiologists, Anatomists and Surgeons, coming from the main Schools that gave to the scientific community some of the cornerstones that led to understand and treat vertigo, described in this book their experience in the diagnosis and management of dizzy patients.

This textbook includes about a thousand references and explicative illustrations, tables and figures that help the readers during the study of the argument. The chapters discuss about the main disease and syndrome causing vertigo, starting from the basic sciences (anatomy and physiology), coming through the diagnostic pathway available for the clinicians, and ending with the treatment section divided in medical therapy and rehabilitation.

For this reason, we consider this volume a complete reference for all the students and physicians who are interested in the complex but basic world of vertigo.

We thank the M/s Jaypee Brothers Medical Publishers (P) Ltd. New Delhi, India, for strongly believing in our project and the editorial staff who steadily supported our work.

A special thanks to Prof. Carlo Dispenza, ENT Department of University of Palermo, Italy, for his master teaching during the training period and for passing the love to the ENT discipline.

We sincerely thank Prof. Carmine Di Ilio Rector Magnificus (Chancellor) of “G. d'Annunzio” University of Chieti-Pescara, Italy, without whose help many of our dreams would not have been fulfilled.

Thanks to Dr Ettore Bennici who always supported our requests to develop the study and research in the field of otology and neurotology.

Thanks also to Prof. Adelchi Croce for his willingness and to Dr Danilo Patrocinio for his kindness.16