Co-occurrence of Otologic Disorders and Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-Analysis

This systematic review was performed to investigate the co-occurrence of otologic disorders and benign paroxysmal positional vertigo (BPPV).

Searches were conducted in PubMed and Web of Science. The review included all original English-language studies-ranging from full-text clinical trials to case reports-enrolling participants aged ≥18 years. Articles were classified into two groups: group 1 comprised studies reporting otologic disorders in patients diagnosed with BPPV; group 2 comprised studies reporting instances of BPPV among patients with otologic disorders. The frequency of each condition was analyzed using descriptive statistics. Meta-analyses were performed using a random-effects model to estimate overall prevalence in both groups.

The initial search yielded 3,407 records, of which 68 articles were included in the analysis. In group 1 (19 studies), 11.4% of patients with BPPV (932/8,157) had co-occurring otologic disorders. Sudden sensorineural hearing loss (present in 11.9% of patients in relevant included studies) and acute unilateral vestibulopathy/vestibular neuritis (5.0%) were most frequently reported. Meta-analysis produced pooled prevalence rates of 11.8% (95% CI, 3.1%-35.7%) for sudden sensorineural hearing loss and 6.5% (95% CI, 3.7%-11.2%) for acute unilateral vestibulopathy/vestibular neuritis. In group 2 (49 studies), 9.7% of patients with otologic disorders (1,106/11,457) experienced concurrent BPPV, with Menière's disease exhibiting the highest rate of concurrence (10.2%). Meta-analyses showed pooled prevalence rates of 10.4% (95% CI, 6.2%-16.8%) for acute unilateral vestibulopathy/vestibular neuritis and 9.1% (95% CI, 4%-19.1%) for Menière's disease.

The co-occurrence of otologic disorders and BPPV is prevalent. These findings underscore the need for mutual clinical screening and may inform understanding of the etiologies underlying BPPV.