Comorbid benign paroxysmal positional vertigo in idiopathic sudden sensorineural hearing loss:  an ominous sign for hearing recovery.
OBJECTIVE
To determine characteristics and their prognostic value in idiopathic sudden sensorineural hearing loss (ISSNHL) with comorbid ipsilateral benign paroxysmal positional vertigo (BPPV).


METHODS
Retrospective chart review.


METHODS
Tertiary referral center.


METHODS
Of the 374 patients with a diagnosis of ISSNHL at Seoul National University Bundang Hospital from January 2004 to December 2009, 32 patients (8.6%) with comorbid BPPV were recruited and compared with matched ISSNHL patients without BPPV.


METHODS
Otologic and neurotologic examinations, pure-tone audiometry (PTA), vestibular function tests, and brain magnetic resonance imagings.


METHODS
Comparison of the findings of serial audiograms for 6 months and vestibular function tests in patients with ISSNHL and concurrent BPPV with those in age-matched ISSNHL patients without BPPV.


RESULTS
Patients with BPPV showed higher PTA averages than those without BPPV on initial and follow-up audiograms. Moreover, the improvement in PTA was less in the BPPV group than in the control. BPPV most commonly involved the posterior canal (17/32, 53.1%), followed by the horizontal canal (8/32, 25%), both the posterior and horizontal canals (6/32, 18.8%), and the anterior canal (1/32, 3.1%). Thirteen (40.6%) of 32 patients had recurrences of BPPV, 9 within a week and another 2 within 3 months.


CONCLUSIONS
Comorbid BPPV is a negative prognostic indicator of auditory function in ISSNHL. Concurrent BPPV in ISSNHL suggests combined damage to the utricle and may indicate severe and widespread labyrinthine damage, leading to the poor prognosis.
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Jae-Jin
JJ
Song
Young-Tae
YT
Yoo
Yong-Hwi
YH
An
Jae Chul
JC
Yoo
Ji Soo
JS
Kim
Ja-Won
JW
Koo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D065635:Benign Paroxysmal Positional Vertigo; D002150:Caloric Tests; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D014717:Vertigo / Q000209:etiology*; D058585:Vestibular Evoked Myogenic Potentials / Q000502:physiology; D014724:Vestibular Function Tests; D055815:Young Adult