A multicenter observational study on the role of comorbidities in the recurrent episodes of benign paroxysmal positional vertigo.
OBJECTIVE
Primary objective of this study was to find a statistical link between the most worldwide comorbidities affecting the elderly population (hypertension, diabetes, osteoarthrosis, osteoporosis and depression) and recurrent episodes of BPPV. Secondary objective was defining possible "groups of risk" for people suffering recurrent positional vertigo related to the presence of a well documented comorbidity.


METHODS
This was an observational, cross-sectional, multicenter, spontaneous, non-pharmacological study. The data of 1092 patients suffering BPPV evaluated in 11 different Departments of Otolaryngology, Otoneurology and Neurology, referring Centers for positional vertigo evaluation, were retrospectively collected.


RESULTS
Regarding evaluated comorbidities (hypertension, diabetes, osteoarthrosis, osteoporosis and depression), data analysis showed the presence of at least one comorbid disorder in 216 subjects (19.8%) and 2 or more in 408 subjects (37.4%). Moreover there was a statistical significant difference between the number of comorbidities and the number of recurrences, otherwise said as comorbidity disorders increased the number of relapses increased too.


CONCLUSIONS
The presence of a systemic disease may worsen the status of the posterior labyrinth causing a more frequent otolith detachment. This condition increases the risk for patients suffering BPPV to have recurrent episodes, even if correctly managed by repositioning maneuvers. The combination of two or more of aforementioned comorbidities further increases the risk of relapsing BPPV, worsened by the presence of osteoporosis. On the basis of this results it was possible to define "groups of risk" useful for predicting BPPV recurrence in patients with one or more comorbidity.
ENT Institute, Department of Oral and Nano-Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara, Italy. Electronic address: dr.adestefano@gmail.com.
Alessandro
A
De Stefano
Department of Otorhinolaryngology, "San Giovanni di Dio" Hospital of Agrigento, University of Palermo, Italy.
Francesco
F
Dispenza
Laboratory of Otoneurology, British Hospital of Montevideo, "CLAEH" School of Medicine, Montevideo, Uruguay.
Hamlet
H
Suarez
Department of Otorhinolaryngology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain.
Nicolas
N
Perez-Fernandez
Department of Otorhinolaryngology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain.
Raquel
R
Manrique-Huarte
Department of Otolaryngology, SKKU University of Seoul, South Korea.
Jae Ho
JH
Ban
Min-Beom
MB
Kim
Department of Otolaryngology, SKKU University of Seoul, South Korea.
Min Beom
MB
Kim
Department of Neurology "Ludwig-Maximilians", University of Munich, Germany.
Michael
M
Strupp
Department of Neurology "Ludwig-Maximilians", University of Munich, Germany.
Katharina
K
Feil
Department of Otorhinolaryngology, University of Brasilia, Brazil.
Carlos A
CA
Oliveira
Department of Otorhinolaryngology, University of Brasilia, Brazil.
Andres L
AL
Sampaio
Department of Otorhinolaryngology, University of Brasilia, Brazil.
Mercedes F S
MF
Araujo
Department of Otorhinolaryngology, University of Brasilia, Brazil.
Fayez
F
Bahmad
Department of Otolaryngology, Federal University of Saõ Paulo, Brazil.
Mauricio M
MM
Ganança
Department of Otolaryngology, Federal University of Saõ Paulo, Brazil.
Fernando F
FF
Ganança
Department of Otolaryngology, Federal University of Saõ Paulo, Brazil.
Ricardo
R
Dorigueto
Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea.
Hyung
H
Lee
Department of Otolaryngology, KIMS Hospital of Kasaragod, India.
Gautham
G
Kulamarva
RNT Medical College of Udaipur, India.
Navneet
N
Mathur
Department of Pharmacy, "G. d'Annunzio" University of Chieti-Pescara, Italy.
Pamela
P
Di Giovanni
Postgraduate School of Public Health and Preventive Medicine, "G. d'Annunzio" University of Chieti-Pescara, Italy.
Anna Grazia
AG
Petrucci
Department of Medicine and Aging, "G. d'Annunzio" University of Chieti-Pescara, Italy.
Tommaso
T
Staniscia
ENT Institute, Department of Oral and Nano-Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara, Italy.
Leonardo
L
Citraro
ENT Institute, Department of Oral and Nano-Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara, Italy.
Adelchi
A
Croce
D000368:Aged; D000369:Aged, 80 and over; D001208:Asia / Q000453:epidemiology; D065635:Benign Paroxysmal Positional Vertigo; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D010003:Osteoarthritis / Q000453:epidemiology; D010024:Osteoporosis / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012665:Semicircular Canals / Q000503:physiopathology; D013020:South America / Q000453:epidemiology; D014717:Vertigo / Q000453:epidemiology* / Q000503:physiopathology
ASC; BPPV; CRM; Comorbidity; Diabetes; Elderly; HSC; Hypertension; Neurology; OA; OR; Osteoarthrosis; Osteoporosis; Otolaryngology; PSC; Vertigo; anterior semicircular canal; benign paroxysmal positional vertigo; canalith repositioning maneuver; horizontal semicircular canal; odds ratio; osteoarthrosis; posterior semicircular canals