变应性鼻炎患者的心理学特点及影响因素分析

目的 观察变应性鼻炎(allergic rhinitis,AR)患者的心理学特点,分析其相关影响因素.方法 采用心理症状自评量表(Symptom Checklist 90,SCL-90)对377例AR患者进行评估,与我国标准常模进行对比,并分析相关影响因素.结果 AR患者中10%心理健康状态不佳,13%处于心理亚健康状态,77%心理状况良好.AR患者在躯体化、强迫症状、焦虑、敌对以及精神病性上的表现与常模的差异具有统计学意义(t值分别为7.128、3.943、2.777、6.423和7.507,P值均＜0.01).男性AR患者在强迫、抑郁、焦虑、偏执和精神病性方面得分高于女性AR患者,差异具有统计学意义(t值分别为2.680、1.977、2.539、2.107和2.844,P值均＜0.05).不同病程分组的强迫症状、恐怖症状得分差异有统计学意义(F值分别为2.379、2.255,P值均＜0.05).是否合并哮喘和(或)湿疹对强迫症状、人际关系敏感、抑郁、偏执以及精神病性方面得分有影响,两组差异有统计学意义(t值分别为6.835、8.914、7.254、13.358、6.030,P值均＜0.01).年龄、AR分型、患者受教育程度、变应原种类以及鼻塞、喷嚏、流涕对SCL-90各因子得分没有影响(P值均＞0.05).鼻痒对抑郁的影响显著(标准化回归系数为0.126,t=2.076,P＜0.05).结论 AR患者的心理健康程度差于常模,掌握AR患者的心理学特点,对提高AR综合治疗效果可能具有意义.     

突发性聋患者的心理健康状况分析

目的 了解突发性聋患者的心理健康状况,为辅助治疗提供参考依据.方法 采用症状自评量表(SCL-90)对59例突发性聋患者进行调查,并与正常人常模进行比较.结果 本组突发性聋患者的SCL-90总分为137.60±42.38分,SCL-90 各因子得分普遍高于正常成人常模,其中躯体化、抑郁及恐怖得分与正常成人常模比较差异有统计学意义(P<0.05),焦虑、精神病性及阳性项目数得分与正常成人常模比较差异有显著统计学意义(P<0.01).结论 与正常成人常模比较,突发性聋患者心理健康状况整体较差,在躯体化、抑郁、焦虑、恐怖、精神病性各项因子上的负性情绪表现更为明显;对突发性聋患者在药物治疗的同时应辅以心理治疗,必要时辅以抗抑郁或抗焦虑药治疗.     

良性阵发性位置性眩晕的认知行为治疗

目的研究认知行为治疗在良性阵发性位置性眩晕(BPPV)治疗中的作用。方法24例确诊为BPPV且焦虑抑郁量表(HADS)评分提示有显著临床精神性症状的患者被随机分为观察组(手法复位+药物治疗+认知行为治疗)和对照组(手法复位+药物治疗),每组12例。在治疗前及治疗后2周分别进行眩晕残障程度评定量表(DHI)、焦虑抑郁量表(HADS)及视觉模拟量表(VAS)评估。结果治疗后,观察组与对照组DHI躯体评分无显著差异(2.00±1.48比2.50±1.51,P0.05);观察组与对照组DHI情感评分(3.50±1.93比6.00±3.52)、DHI功能评分(6.67±2.74比10.33±3.89)、HADS评分(7.17±1.99比10.58±4.50)及VAS评分(0.58±0.67比1.25±0.87)之差异均具有显著统计学意义,均P0.05。结论认知行为治疗可改善BPPV患者的情感及功能症状,缓解其焦虑、抑郁情绪,提高生活质量。     

单侧特发性耳鸣临床特点和情绪、认知特征的对比分析及相关性研究

目的　分析左、右侧特发性耳鸣临床特点和情绪、认知状态差异及相关性。方法　入选左、右侧耳鸣各44、36例,采集临床资料及耳鸣障碍评估量表（tinnitus handicap inventory,THI）、贝克抑郁量表（Beck depression inventory,BDI）、状态特质焦虑量表（state trait anxiety inventory,STAI）、蒙特利尔认知评估量表（Montreal cognitive assessment,MoCA）评估。结果　男性左侧耳鸣发生率明显高于女性患者（68.2% vs 31.8%）。左侧耳鸣伴听力下降发生率明显高于右侧（90.9% vs 69.4%）。两组间 年龄、体质量指数（BMI）、受教育年限、耳鸣持续时间、听力阈值和THI、BDI、状态焦虑量表（S-AI）、特质焦虑量表（T-AI）、MoCA评分无显著性差异。影响日常生活和睡眠、抑郁、状态焦虑、特质焦虑和认知损害的发生率是23.8%、33.8%、17.5%、6.3%和33.8%。耳鸣严重程度与抑郁、状态焦虑、特质焦虑和认知功能损害呈正相关,耳聋严重程度与认知功能损害呈正相关。结论　单侧特发性耳鸣较严重,抑郁、焦虑和认知损害发生率高且与耳鸣和耳聋严重程度密切相关。     

三线减张鼻中隔成形术患者围手术期心理状态评估

目的　观察鼻中隔偏曲患者的心理学特点,分析三线减张鼻中隔成形术前后心理学变化。方法　采用心理症状自评量表（symptom checklist 90,SCL-90）、焦虑 自评量表（self-rating anxiety scale,SAS）和抑郁自评量表（self-rating depression scale,SDS）对2016年9月～2017年9月北京同仁医院139例鼻中隔偏曲患者进行评估,与我国标准常模进行对比,并观察术后心理学变化。用SPSS20.0软件对数据进行统计学分析。结果　鼻中隔偏曲患者中,心理健康者占81%,心理受损轻度及以上占19%。患者SCL-90量表在躯体化、强迫症状、抑郁、焦虑以及精神症状上得分高于常模,差异具有统计学意义（t 分别为6.270、3.655、2.083、4.082、4.218,P 均＜0.05）。患者的SAS、SDS评分高于常模,差异具有统计学意义（t 分别为9.75、3.142,P 均＜0.01）。术后鼻中隔偏曲患者的躯体化、抑郁、焦虑明显减轻,与术前差异具有统计学意义（t 分别为2.171、3.49、2.934,P 均＜0.05）。术后鼻中隔偏曲患者SDS、SAS评分明显降低,与术前差异具有统计学意义（t 分别为6.287、9.378,P 均＜0.01）。结论　部分鼻中隔偏曲患者的心理健康程度低于国内常模,存在明显抑郁、焦虑症状,三线减张鼻中隔成形术可缓解部分患者躯体化、抑郁、焦虑症状。     

中青年女性BPPV发病危险因素分析

目的 探讨中青年女性良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)发病的危险因素.方法 以2016年7月～2019年12月确诊的145例中青年女性BPPV患者为研究对象,其中原发性113例(原发组),继发性32例(继发组);以98例正常中青年女性为对照组;原发...     

44例突发性聋住院患者心理状况临床分析

目的通过心理测评相关量表评估突发性聋患者的心理健康状况。方法 44例突发性聋患者和正常人44例使用焦虑(SAS)和抑郁自评量表(SDS)、SCL-90量表进行对比评估心理状况。结果突发性聋患者的SAS、SDS测评结果和正常人得分比较(P<0.01)有统计学意义。SCL-90总分143.91±38.57分,高于正常成人总分140.07±36.53分,SCL-90中各项得分普遍高于正常人,抑郁、恐怖得分和正常人比较有统计学差异(P<0.05),躯体化、焦虑、精神病性评分与正常人比较差异有显著统计学意义(P<0.01)。结论突聋患者常伴焦虑抑郁、心理状况差,突聋的发病可能与心理因素有关,突聋的患者需重视心理问题,消除患者的焦虑和抑郁状况,在药物治疗的基础上联合心理治疗。     

水平半规管良性阵发性位置性眩晕患者眼震参数客观特征

目的 探讨水平半规管良性阵发性位置性眩晕(BPPV)眼震的方向、强度、时间等参数的客观特征及机制.方法 水平半规管BPPV患者233例,其中水平半规管管石症(horizontal semicircular canalithasis,HSC-Can) 179例,水平半规管壶腹嵴顶结石症(horizontal semicircular canal cupulolithiasis,HSC-Cup)54例.应用视频眼震图仪分别记录滚转试验诱发眼震,比较各个试验头位的眼震方向、强度、时间等参数特点.采用SPSS17.0统计软件进行数据处理.结果 水平半规管BPPV患者滚转试验在左侧、右侧转头位均可诱发出水平性眼震.HSC-Can诱发眼震方向与转头方向相同,向患侧和健侧转头位诱发眼震的潜伏期(-x±s,下同)为(1.922±1.501)s和(1.447±0.855)s,持续时间为(25.620±10.409)s和(22.110±10.931)s,强度为(56.441±33.168)°/s和(24.239±13.892)°/s,向患侧转头诱发眼震的潜伏期、持续时间及强度均大于健侧,差异均具有统计学意义(t值分别为3.715、15.219和4.070,P值均＜0.01),其中眼震强度之比约为2∶1.HSC-Cup诱发眼震方向与转头方向相反,向健侧转头诱发眼震的强度明显大于向患侧转头,其强度之比约为2∶1,差异具有统计学意义(t=-7.634,P＜0.01);而向健侧和向患侧转头诱发眼震的潜伏期,差异则无统计学意义(t=1.670,P=0.101).HSC-Can滚转试验中向患侧转头诱发眼震的潜伏期、强度均大于HSC-Cup向健侧转头,但差异无统计学意义(t值分别为1.554和0.305,P值均＞0.05).结论 水平半规管BPPV患者滚转试验向左右侧转头诱发眼震的强度均遵循Ewald定律,强弱之比约为2∶1;潜伏期、持续时间及强度等眼震图参数可作为BPPV的客观诊断指标.     

心理状态与不同分型突发性聋的相关性及其影响因素分析

目的 探讨心理状态与不同分型突发性聋的相关性及其影响因素。方法 采用一般情况问卷和症状自评量表（SCL-90）对确诊的456例不同分型的突聋患者进行心理状况评估,以中国常模作为对照组行对比研究。结果各型突聋组心理状态总均分均高于健康对照组,且组间比较差异有统计学意义（P<0.05）,平坦型分值最高,低频下降型分值最低。人际关系敏感因子得分平坦型和全聋型高于健康组,焦虑、其他（饮食和睡眠障碍）因子得分各型均高于健康组,抑郁因子得分高频下降型、平坦型和全聋型高于健康组（P均<0.05）,其余因子得分差异无统计学意义（P>0.05）。多元回归结果显示：文化程度、工作性质和性别依次为突聋患者心理状况的影响因素;初中及以下学历组人际关系敏感、焦虑、抑郁、其他（饮食和睡眠障碍）因子分均高于高中及以上组;脑力劳动者焦虑、抑郁、其他（饮食和睡眠）因子分均高于体力劳动者,躯体化因子分低于体力劳动者;女性焦虑、抑郁因子分高于男性（P均<0.05）。结论 不同分型突聋患者存在不同程度的心理障碍,有症状的心理因子在各型分布不同。低学历、脑力劳动者、女性依次对突聋心理状态有影响,建议临床...     

良性阵发性位置性眩晕发病侧别和患者睡眠侧别的相关性

目的探讨良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者发病侧别和患者习惯性的睡眠侧别的相关性。方法详细记录2007年1月～2008年4月头晕门诊经Dix-Hallpike及rolltest试验明确诊断BPPV患者261例,将患者按照有无诱因分为特发性BPPV和继发性BPPV两组,比较两组患者发病侧别和睡眠侧别的相关性;再将患者按照累及半规管的类型分为后半规管良性阵发性位置性眩晕(posterior semicircular BPPV,PC-BPPV)、水平半规管BPPV(horizontal semicircular BPPV,HC-BPPV)和前半规管BPPV(anterior semicircular BPPV,AC-BPPV),分别比较3个组患者中发病侧别和睡眠侧别的相关性。结果 261例患者中,男性75例,女性186例,男:女为1:2.48。患者年龄14～85岁,平均(57±13.764)岁,BPPV病史1d～10年。①按照有无诱因将BPPV患者分为无诱因的特发性BPPV和有诱因的继发性BPPV,将特发性BPPV组患者和继发性BPPV组患者发病侧别和睡眠侧别进行Spearman Correlation相关性检验,特发性组r=0.233,P<0.05,相关性有统计学意义,继发性组r=0.157,P>0.05,相关性无统计学意义。②按照病变部位分为PC-BPPV、HC-BPPV和AC-BPPV,将3个组发病侧别和睡眠侧别进行Spearman Correlation相关性检验,PC组r=0.175,P=0.052>0.05,AC组r=0.730,P=0.062>0.05,HC组r=0.252,P=0.117>0.05,3个组都没有统计学意义。结论特发性BPPV组患者发病侧别和睡眠侧别有一定的相关性,对于判断患病侧别有一定意义。     

Prevalence of anxiety and depression in Meniere's disease; a comparative analytical study

BackgroundPsychological problems are of most significant issues in patients with Meniere's disease (MD). This study aimed to reveal the frequency of anxiety and depression in MD patients compared to healthy individuals and patients with benign positional paroxysmal vertigo (BPPV) referred to a university hospital.MethodsThis case-control study was conducted on individuals between 18 and 65 years old assigned to three groups: the control, MD, and BPPV groups. The data collecting instruments included a demographic information form, along with Beck Anxiety Inventory (BAI) and Beck Depression Inventory-II (BDI-II) questionnaires. Data were analyzed using SPSS software v.23, and the significance level was considered as p < 0.05.ResultsA total of 177 participants enrolled. The average scores of anxiety and depression and the severity of anxiety and depression were higher in MD and BPPV groups than in the control group (P < 0.001). The average anxiety score and anxiety severity in the MD group was higher than in the BPPV group (P < 0.001). However, in the case of depression, only severity was higher in the MD group (P < 0.001), and the average depression score showed no significant difference between MD and BPPV groups. After controlling for underlying variables, the impacts of MD (P < 0.001; regression coefficient = 16.5) and also BPPV (P = 0.025; regression coefficient = 4.6) on anxiety were significant compared to the control group.ConclusionOur results suggest that the prevalence of anxiety and depression is higher in MD and BPPV patients than the healthy people, and MD has a higher effect on the incidence of depression and anxiety compared to BPPV.     

Mood improvement after surgery for obstructive sleep apnea

OBJECTIVE: Patients with obstructive sleep apnea (OSA) may experience unfavorable psychologic symptoms such as depression and anxiety. The aim of this study was to confirm this hypothesis and to investigate whether the psychologic symptoms among OSA patients can be relieved by surgical intervention. STUDY DESIGN: Prospective, longitudinal intervention study. METHODS: The 5-Item Mental Health scale (MH-5) was used to evaluate the postoperative changes of mood after extended uvulopalatal flap (EUPF) surgery on 84 Taiwanese patients with OSA. The preoperative and postoperative MH-5 data obtained from these patients were compared with a Taiwanese population norm. RESULTS: Before surgery, the MH-5 scores of the OSA patients were significantly worse than the Taiwanese population norm of 72.8 (P <.0001). Postoperatively, mean MH-5 scores significantly increased from 61.8 +/- 16.0 to 70.0 +/- 15.8 (P =.0006). The effect size of this score change was 0.51, indicating a moderate degree of mood improvement. However, this score was still inferior to that of the population norm (P =.0045). The mood improvement was not significantly associated with the changes in either sleep apnea events or the level of sleepiness. Neither the changes in respiratory disturbance index (P =.4382), maximum arterial oxygen saturation (P =.4866), nor the change in Epworth Sleepiness Scale scores (P =.4951) were predictive of the MH-5 score improvement (R = 0.07). CONCLUSIONS: This study demonstrated that patients with OSA had a higher level of anxiety, depression, and probable behavior or personality changes than the population norm. EUPF surgery could significantly improve the mood status among OSA patients; the effect of surgery was mild but clinically relevant. However, the extent of mood improvement experienced by OSA patients receiving operations may not simply be attributable to the changes in sleep apnea events or a reduced level of sleepiness.     

Usefulness of the dizziness handicap inventory in the screening for benign paroxysmal positional vertigo.

OBJECTIVE: The purpose of the study was to determine whether a newly developed subscale of the Dizziness Handicap Inventory (DHI) could assist in the screening of benign paroxysmal positional vertigo (BPPV). STUDY DESIGN: Retrospective case review. SETTING: Tertiary balance referral center. PATIENTS: Charts of 383 patients (mean age, 61 yr) with a variety of vestibular diagnoses (peripheral and central) were reviewed. INTERVENTIONS: Patients completed the DHI before the onset of physical therapy intervention. MAIN OUTCOME MEASURES: A newly developed BPPV subscale developed from current DHI items was computed to determine whether the score could assist the practitioner in identifying individuals with BPPV. RESULTS: Individuals with BPPV had significantly higher mean scores on the newly developed BPPV subscale of the DHI (p < 0.01). The five-item BPPV score was a significant predictor of the likelihood of having BPPV (chi2 = 8.35; p < 0.01). On the two-item BPPV scale, individuals who had a score of 8 of 8 were 4.3 times more likely to have BPPV compared with individuals who had a score of 0. CONCLUSION: Items on the DHI appear to be helpful in determining the likelihood of an individual having the diagnosis of BPPV.     

眼震电图与动态姿势图在良性阵发性位置性眩晕中的临床应用

目的:探讨眼震电图(ENG)及动态姿势描记(DPG)2种前庭功能检查在良性阵发性位置性眩晕(BPPV)中的临床应用。方法:应用ENG与DPG对40例34～79岁的原发性BPPV患者(BPPV组)和20例正常者(对照组)进行检查,其中DPG评定参数选取感觉器官测试(SOT)中前庭感觉评分、本体感觉评分、视觉评分、Romber′s评分和综合评分。结果:40例BPPV患者的ENG检查中,温度试验异常者26例(65.0%);DPG异常者33例(82.5%),并且DPG中均表现为前庭觉评分低,其他几项评分均未见差别。温度试验和DPG两项结果均异常者24例(60.0%),温度试验正常患者中有9例(64.3%)出现前庭觉评分低,在SOT中除前庭觉评分低外其他几项评分均未见明显异常。此外,与对照组比较BPPV组ENG中温度试验和DPG的前庭评分明显异常(P<0.05),并且≥12个月患者上述检查异常程度更高(P<0.05)。结论:ENG与DPG是重要的前庭功能检查方法,二者联合应用能够全面分析BPPV患者前庭功能病变,且BPPV患者病程直接影响其前庭功能。     

Low 25-hydroxyvitamin D levels in postmenopausal female patients with benign paroxysmal positional vertigo

Objective: Several studies have reported the association of benign paroxysmal positional vertigo (BPPV) with vitamin D deficiency. This study aimed to evaluate serum 25-hydroxy vitamin D (25 (OH) D) levels in native Chinese postmenopausal women with de novo idiopathic BPPV and to investigate the possible relationship between the occurrence of BPPV and low 25 (OH) D levels.

Methods: This retrospective study comprised of 85 postmenopausal women with de novo idiopathic BPPV and 80 age-matched healthy controls. All subjects had bone mineral density (BMD) and serum 25 (OH) D levels measurements recorded, and the results were compared.

Results: The prevalence of reduced BMD (T score?p?=?.004). The mean serum 25 (OH) D levels were also significantly lower in female patients with BPPV than in healthy controls (19.1?±?5.2 vs. 22.5?±?5.8, p?p?=?.031).

Conclusion: Our study suggests that low 25 (OH) D may be a risk factor for BPPV in postmenopausal women.     

The effects of abnormality of cVEMP and oVEMP on rehabilitation outcomes in patients with idiopathic benign paroxysmal positional vertigo

The presence of utricular and saccular dysfunction impairs quality of life (QoL) in patients. The aims of the present study were to examine the effect of repositioning maneuvers on QoL of patients with idiopathic benign paroxysmal positional vertigo (BPPV) and to describe the effect of cervical vestibular-evoked myogenic potential (cVEMP) or ocular VEMP (oVEMP) abnormalities on patient recovery after rehabilitation. Thirty idiopathic BPPV patients with/without otolith dysfunctions (n = 15, each group) were included in this clinical trial study. Otolith dysfunction was determined using oVEMP and cVEMP abnormalities. EcochG and caloric tests were performed to rule out other causes of secondary BPPV. The QoL in groups of patients with idiopathic BPPV was assessed using a Persian version of the dizziness handicap inventory (DHI-P) before and after treatment with Epley’s maneuver. Pre-treatment results showed significant handicaps in both groups. DHI-P scores were higher in BPPV patients with otolith dysfunction (total, functional, emotional, physical score: 34.13, 11.20, 7.06, 15.86, respectively) than those in patients without otolith dysfunction (total, functional, emotional, physical score: 25.46, 7.86, 6.13, 11.46, respectively, P < 0.05). After treatment, DHI-P scores decreased in both groups. However, in the otolith dysfunction group, DHI-P scores (total, functional, emotional, physical score: 9.20, 3.33, 1.33, 4.53, respectively) were higher than those in patients without otolith dysfunction (total, functional, emotional, physical score: 4.13, 0.93, 1.06, 2.00, respectively). In BPPV patients with cVEMP or oVEMP abnormalities, QoL is more compromised in comparison with that in BPPV patients without these dysfunctions. Otolith dysfunction enhances the negative effects of BPPV on QoL.     

The evaluation of anxiety and panic agarophobia scores in patients with benign paroxysmal positional vertigo on initial presentation and at the follow-up visit

Conclusion: Patients with BPPV experienced short but intense anxiety and/or panic disorder, especially at the initial visit, but most patients recovered without medication with successful treatment.

Objective: Recent studies have shown that people with dizziness report some psychological problems such as panic and agoraphobia and anxiety. The aim of this study was to evaluate anxiety and panic agorophobia levels in patients with benign paroxysmal positional vertigo on initial presentation and at the follow-up visit and compare the scores with the control group.

Methods: All the 32 patients in the study had a diagnosis of BPPV confirmed by their history, typical subjective symptom reports, and characteristic positional nystagmus during the Dix–Hallpike test and/or Roll test. The patients were instructed to complete the standard forms of Beck anxiety inventory and panic agoraphobia scale questionnaire before and at 7 and 14 days after the canalith repositioning treatment.

Results: The validity scores of panic agoraphobia were statistically significantly higher in patients with BPPV than in the control group in each period (p?p?相似文献   

Benign paroxysmal positional vertigo and comorbid conditions

PURPOSE: To determine the prevalence of comorbid disease in patients with benign paroxysmal positional vertigo (BPPV) and the relationship of comorbid disease to symptoms of vertigo, disequilibrium, and anxiety. PROCEDURES: Patients who had posterior semicircular canal BPPV and who had been referred for vestibular rehabilitation at a tertiary care center completed a health status questionnaire and the Vertigo Symptom Scale, answered questions about level of vertigo, and were tested on computerized dynamic posturography. RESULTS: Subjects had high rates of diabetes, mild head trauma, and probable sinus disease. Balance was generally impaired, worse in diabetics and subjects with significant vestibular weakness. Subjects who smoked or had had mild head trauma had higher levels of anxiety. CONCLUSIONS: Comorbid conditions, particularly diabetes, mild head trauma, and sinus disease, are unusually prevalent in BPPV patients. Message: Patients with comorbid disease are at risk for having increased vertigo, anxiety, and disequilibrium compared to other patients.     

Results of singular neurectomy in the posterior ampullary recess

OBJECTIVE: To determine the effect on hearing and balance symptoms following singular neurectomy (SN) for benign paroxysmal positional vertigo (BPPV) in the ampullary recess of the posterior semicircular canal. RESEARCH DESIGN: The charts of 242 patients with chronic disabling BPPV who were treated with SN over a 29-year period (1972-2001) were reviewed. The results on relief of BPPV and hearing function were recorded. A subset of 16 patients where the posterior ampullary recess was entered to expose the SN is described in detail with regard to an effect on hearing and balance. RESULTS: A total of 252 SN were performed in 242 patients. Ten patients underwent bilateral SN sequentially; the remaining 232 patients had unilateral SN. The ages of the patients ranged from 21 to 86 years, with a mean at 57 years. The female:male ratio was 174:68. Complete relief of BPPV was achieved in 244 patients (96.8%), incomplete relief in 3 (1%), and no relief in 5 (2%). Sensorineural hearing loss (SNHL) occurred in 9 patients (3.7%). A subset of 16 patients in whom the ampullary recess was opened during SN ranged in age from 21 to 79 years, with a mean at 56 years. The female:male ratio was 12:4, with right and left sides divided almost equally. Relief of BPPV was achieved in all 16 patients with no loss of hearing function. Five patients complained of a fistula response postoperatively (31%). The fistula response resolved by 6 months postoperatively in all 5 patients. CONCLUSIONS: SN is effective in relief of BPPV with little risk of SNHL (3.7%). The risk of SNHL is not increased when the posterior ampullary recess must be entered in order to transect the singular nerve. A positive fistula response may be present temporarily in almost one third of these patients.     

Comorbidities and recurrence of benign paroxysmal positional vertigo: personal experience

Objective: The aim of this study is to evaluate the correlation between clinical features of benign paroxysmal positional vertigo (BPPV) and age, sex, trauma, presence of one or more comorbidities such as cardiovascular, neurological, endocrinological, metabolic, psychiatric diseases. Design: Retrospective review of medical records (chart review). Study sample: A total of 475 patients aged from 14 to 87 years, affected by BPPV. Results: Recurrence of BPPV occurred in 139/475 patients (29.2%). The recurrence rate was significantly higher in female and older patients. Comorbidities were present in 72.6% of subjects with recurrent BPPV vs. 48.9% of patients with no recurrence (p?<0.01). Forty-two patients (8.8%) reported a cranial trauma as a triggering event. Post-traumatic patients showed a significantly higher persistence rate (45.2%) compared to patients affected by non-traumatic BPPV (20.5%). Recurrence rates are overlapping between the two groups. Conclusion: Our results confirm the association between recurrence of BPPV and age, female sex, and presence of comorbidities. The correlation is stronger in patients affected by multiple associated diseases; the most frequently involved pathologies are psychiatric disorders, followed by neurological and vascular diseases. Collecting a complete medical history is important for prognostic stratification and detection of potential underlying pathological conditions.