Idiopathic benign paroxysmal positional vertigo with persistent vertigo/dizziness sensation is associated with latent canal paresis, endolymphatic hydrops, and osteoporosis

Objectives: This study was performed to determine characteristics and the prognostic values in idiopathic sudden sensorineural hearing loss (SSNHL) with comorbid ipsilateral canal paresis (CP) and/or benign paroxysmal positional vertigo (BPPV). Methods: Of the 338 patients with a diagnosis of idiopathic SSNHL, 29 patients (8.6%) with CP and 24 patients (7.1%) with BPPV were recruited and compared to 23 patients with SSNHL and vertigo but without CP or BPPV. The patients were evaluated for their initial hearing threshold, type of canal involved, response to repositioning maneuvers, and hearing outcome for 6 months. Results: Patients with CP (+) BPPV (‒) showed lower pure-tone averages than those with CP (‒) BPPV (+) on initial and follow-up audiograms. The improvement in pure-tone averages was less in the CP (+) BPPV (‒) group than in the CP (‒) BPPV (+) group. The improvement in speech discrimination scores was less in the CP (+) BPPV (‒) group than in the CP (‒) BPPV (‒) group. BPPV most commonly involved the posterior canal (15 of 24, 62.5%), followed by the horizontal canal (13 of 24, 54.2%). Three of 24 patients (12.5%) had recurrences of BPPV. Conclusions: CP is a more serious sign for hearing recovery than BPPV, although both CP and BPPV are negative prognostic indicators of auditory function in SSNHL. Concurrent CP and/or BPPV in SSNHL suggest combined damage to the vestibule and may indicate severe and widespread labyrinthine damage, leading to a poor prognosis.

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Association between endolymphatic hydrops and benign paroxysmal positional vertigo: coincidence or casuality?

Acta Otorrinolaringologica (English Edition) ◽

10.1016/s2173-5735(09)70137-1 ◽

2009 ◽

Vol 60 (4) ◽

pp. 234-237

Author(s):

Marcos Rossi Izquierdo ◽

Andrés Soto Varela ◽

Sofía Santos Pérez ◽

Torcuato Labella Caballero

Keyword(s):

Benign Paroxysmal Positional Vertigo ◽

Endolymphatic Hydrops ◽

Positional Vertigo ◽

Paroxysmal Positional Vertigo

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Benign positional vertigo and endolymphatic hydrops: what is the connection?

The Journal of Laryngology & Otology ◽

10.1017/s002221511700130x ◽

2017 ◽

Vol 131 (8) ◽

pp. 658-660 ◽

Cited By ~ 7

Author(s):

A F Jahn

Keyword(s):

Benign Paroxysmal Positional Vertigo ◽

Endolymphatic Hydrops ◽

Positional Vertigo ◽

New Hypothesis ◽

Paroxysmal Positional Vertigo

AbstractBackground:Although benign paroxysmal positional vertigo and endolymphatic hydrops are considered to be distinct diagnoses, a minority of vertiginous patients exhibit features of both conditions. This coincidence has been reported previously in the literature, and is reviewed here in terms of possible aetiology.Results and conclusion:A new hypothesis to account for both conditions is offered, implicating free-floating degenerating debris from the otolithic apparatus. It is postulated that the gelatinous/proteinaceous component may account for an osmotically induced hydrops, while the calcified fragments may induce positional vertigo.

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Benign Paroxysmal Positional Vertigo Secondary to Mild Head Trauma

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489416674961 ◽

2016 ◽

Vol 126 (1) ◽

pp. 54-60 ◽

Cited By ~ 16

Author(s):

Dimitrios G. Balatsouras ◽

George Koukoutsis ◽

Andreas Aspris ◽

Alexandros Fassolis ◽

Antonis Moukos ◽

...

Keyword(s):

Head Trauma ◽

Medical Records ◽

Benign Paroxysmal Positional Vertigo ◽

Spontaneous Nystagmus ◽

Control Group ◽

Imaging Evaluation ◽

Canal Paresis ◽

Positional Vertigo ◽

Anterior Semicircular Canal ◽

Paroxysmal Positional Vertigo

Objectives: We studied the clinical characteristics, nystagmographic findings, and treatment outcome of a group of patients with benign paroxysmal positional vertigo (BPPV) secondary to mild head trauma and compared them with a group of patients with idiopathic BPPV. Methods: The medical records of 33 patients with BPPV associated with mild head trauma were reviewed. Data of a complete otolaryngological, audiological, neurotologic, and imaging evaluation were available for all patients. Three hundred and twenty patients with idiopathic BPPV were used as a control group. Results: The patients with BPPV secondary to mild head trauma presented the following features, in which they differed from the patients with idiopathic BPPV: (1) lower mean age, with more intense symptoms; (2) increased rate of horizontal and anterior semicircular canal involvement and frequent multiple canal and bilateral involvement; (3) greater incidence of canal paresis and presence of spontaneous nystagmus; (4) poorer treatment results, attributed mainly to coexisting canal paresis in many patients, and higher rate of recurrence. Conclusions: Benign paroxysmal positional vertigo associated with mild head trauma differs from idiopathic BPPV in terms of several epidemiological and clinical features; it responds less effectively to treatment and is prone to recurrence.

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