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Using Unidirectional Rotations to Improve Vestibular System Asymmetry in Patients with Vestibular Dysfunction
Published on: August 30, 2019
Benign paroxysmal positional vertigo secondary to inner ear disease
No-Hee Lee1, Jae-Ho Ban, Kyung-Chul Lee
1Department of Otorhinolaryngology-Head and Neck Surgery, Hongik Medical Center, Seoul, Korea.
Summary
Secondary BPPV (s-BPPV) shows varied clinical features compared to idiopathic BPPV (i-BPPV), with longer treatment durations linked to specific inner ear diseases like sudden hearing loss.
Area of Science:
- Otolaryngology
- Neurology
- Vestibular Disorders
Background:
- Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder.
- Secondary BPPV (s-BPPV) arises from underlying inner ear pathologies, contrasting with idiopathic BPPV (i-BPPV).
- Understanding the clinical differences between s-BPPV and i-BPPV is crucial for diagnosis and management.
Purpose of the Study:
- To compare the clinical characteristics of secondary BPPV (s-BPPV) with idiopathic BPPV (i-BPPV).
- To identify demographic differences, associated causative disorders, and affected semicircular canals in s-BPPV.
- To analyze treatment response and duration for s-BPPV in relation to underlying conditions.
Main Methods:
- A retrospective case series involving chart review of 718 BPPV patients.
- Identification of 69 s-BPPV patients with pre-existing inner ear diseases.
- Comparison of demographics, causative disorders, canal involvement, and treatment outcomes between s-BPPV and i-BPPV groups.
Main Results:
- No significant sex difference was observed in s-BPPV, unlike i-BPPV which had more females.
- Common associated conditions for s-BPPV included idiopathic sudden sensory hearing loss (ISSHL), Ménière's disease (MD), and unilateral vestibulopathy.
- Posterior canal was most affected in both types, but MD-associated BPPV predominantly involved the lateral canal. Mean treatment duration was longer for s-BPPV (4.87 days) versus i-BPPV (2.28 days).
Conclusions:
- Treatment duration for BPPV associated with ISSHL or unilateral vestibulopathy was significantly longer.
- Diverse clinical features and courses of s-BPPV are likely due to varying pathophysiologies linked to different inner ear diseases.
- Further research into the specific mechanisms of s-BPPV is warranted.
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