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KMID : 0361020220650010018
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Korean Journal of Otolaryngology - Head and Neck Surgery
2022 Volume.65 No. 1 p.18 ~ p.23
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Clinical Manifestations and Prognosis of Benign Paroxysmal Positional Vertigo according to Etiology
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Jang Wook
Shin Jung-Woo
Kim Sang-Woo
Kim Do-Hyung
Cho Chang-Gun
Park Seok-Won
Lim Yun-Sung
Kim Bo-Hae
Park Joo-Hyun
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Abstract
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Background and Objectives : This work investigates the clinical characteristics of benignparoxysmal positional vertigo (BPPV) according to etiology by comparing idiopathic BPPV(iBPPV), BPPV occurring after head trauma (tBPPV) and BPPV associated with idiopathicsudden sensory neural hearing loss (sBPPV).
Subjects and Method : A total of 869 patients who were diagnosed and treated for BPPVwere reviewed retrospectively. Patients were divided into three groups according to the probableetiology of BPPV: iBPPV vs. tBPPV vs. sBPPV. We investigated and compared demographics,the affected sides and canals, the number of canalith repositioning procedure (CRP) performedto achieve successful reposition, canal conversion and recurrence among the threegroups. Among the three groups, BPPV patients who performed caloric test and/or video headimpulse test (vHIT) were additionally evaluated and compared.
Results : The iBPPV group (n=787) had greater female preponderance (72%, 567/787) thanthe tBPPV (n=51) and sBPPV groups (n=31, p<0.001). The mean number of CRPs needed forsuccessful repositioning in the iBPPV group (1.40±0.03) was significantly (p<0.001) lowerthan that in the tBPPV and sBPPV groups (2.04±0.24 and 2.45±0.36). There was no differencebetween the tBPPV and sBPPV groups. Recurrence rate was not significantly different amongthree groups (14.6% vs. 17.7% vs. 16.2%) statistically. The presence of canal paresis and abnormalresults of vHIT test were not related with a greater number of CRPs required and recurrence.
Conclusion : More CRPs were required for successful repositioning in the tBPPV and sBPPVpatients than in the iBPPV patients and there was no difference between tBPPV and sBPPVpatients. Recurrence rate was not different among the three groups. This information maybe helpful for clinicians in counselling and managing BPPV patients.
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KEYWORD
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Benign paroxysmal positional vertigo, Recurrence, Sudden hearing loss, Trauma
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