Association of Tinnitus with Benign Paroxysmal Positional Vertigo

Background/Objectives: The purpose of this study is to investigate the potential association between tinnitus and benign paroxysmal positional vertigo (BPPV) using large-scale population data to assess the risk of developing one condition in patients who have the other condition. Methods: Using claims data from the National Health Insurance Corporation spanning 2008 to 2021, we conducted a comprehensive analysis to estimate the risk of developing BPPV in patients with tinnitus and vice versa. This study involved 580,531 patients with tinnitus, 572,937 patients with benign paroxysmal positional vertigo, and their corresponding controls. We used propensity score matching and statistical analyses, including Cox proportional hazard models to assess the association between these conditions. Results: The incidence of BPPV in patients with tinnitus was significantly higher (12.3 per 1000 individuals per year) than that of controls (5.1 per 1000 individuals per year), with an adjusted hazard ratio of 2.474. Additionally, the incidence of tinnitus was significantly higher in patients with BPPV (11.7 per 1000 individuals per year) than in controls (5.5 per 1000 individuals per year), with an adjusted hazard ratio of 2.048. Subgroup analysis showed the risk of developing BPPV in people with tinnitus, and vice versa, was higher in young vs. old people (<39 years) and in men vs. women (p<0.0001). These findings remained significant even after adjusting for sex, age, medical benefits, disability, and health habits. Conclusions: This study provides substantial evidence for a bidirectional association between tinnitus and benign paroxysmal positional vertigo, suggesting an interconnected pathophysiology. Further research is warranted to understand the underlying mechanisms.