Benign paroxysmal positional vertigo secondary to inner ear disease.
OBJECTIVE
To contrast clinical characteristics of secondary benign paroxysmal positional vertigo (s-BPPV) with idiopathic BPPV (i-BPPV).


METHODS
Case series with chart review.


METHODS
University hospital.


METHODS
A total of 718 patients whose medical records were reviewed had BPPV. Sixty-nine patients had existing inner ear diseases and thus were considered to have s-BPPV. We reviewed demographics, concurrent causative disorders, involved area, and response to particle repositioning maneuvers for these s-BPPV patients in comparison with i-BPPV subjects.


RESULTS
Female subjects with i-BPPV outnumbered male subjects by a ratio of 1.9:1, but there was no significant sex difference for s-BPPV patients. The diseases associated with s-BPPV were idiopathic sudden sensory hearing loss (ISSHL, 50.7%), Ménière's disease (MD, 28.9%) and unilateral vestibulopathy such as acute vestibular neuronitis and herpes zoster oticus (20.2%). The posterior canal was most commonly involved in both i-BPPV and s-BPPV. The horizontal canal was the second most common, followed by multi-canal involvement. However, MD-associated BPPV most commonly involved the lateral canal. The mean durations of treatment for i-BPPV and s-BPPV were 2.28 and 4.87 days, respectively. The mean duration of treatment was 6.28 days for ISSHL with BPPV, 5.07 days for BPPV with unilateral vestibulopathy, and 2.28 days for BPPV with MD.


CONCLUSIONS
The mean duration of treatment for BPPV with ISSHL or unilateral vestibulopathy was longer than for other groups. The different pathophysiologies of s-BPPV associated with different inner ear diseases may explain its diverse clinical features and courses.
Lee
No-Hee
NH
Department of Otorhinolaryngology-Head and Neck Surgery, Hongik Medical Center, Seoul, Korea.
Ban
Jae-Ho
JH
Lee
Kyung-Chul
KC
Kim
Su Mi
SM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007759:Labyrinth Diseases / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations; D012189:Retrospective Studies; D012307:Risk Factors; D012665:Semicircular Canals; D016896:Treatment Outcome; D014717:Vertigo / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D055815:Young Adult