Effect of dynamic balance during the onset of benign paroxysmal positional vertigo on residual dizziness after successful repositioning: a multicenter prospective cohort study.
10.3760/cma.j.cn115330-20210912-00607
- VernacularTitle:良性阵发性位置性眩晕患者发作期动态平衡功能对复位后残余症状的影响：多中心前瞻性队列研究
- Author:
Pei Xia WU
1
;
Jun YANG
2
;
Xin Sheng HUANG
3
;
Zhao Xin MA
4
;
Tian Zhen ZHANG
5
;
Hua Wei LI
1
Author Information
1. Department of Otorhinolaryngology Head and Neck Surgery, Eye & ENT Hospital Affiliated to Fudan University, Shanghai 200031, China.
2. Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China.
3. Department of Otorhinolaryngology Head and Neck Surgery, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200031, China.
4. Department of Otolaryngology Head and Neck Surgery, Dongfang Hospital Affiliated to Tongji University, Shanghai 200120, China.
5. Department of Otolaryngology Head and Neck Surgery, Shanghai First People's Hospital, Shanghai 200080, China.
- Publication Type:Multicenter Study
- MeSH:
Adult;
Aged;
Benign Paroxysmal Positional Vertigo;
China;
Dizziness;
Female;
Humans;
Male;
Middle Aged;
Prospective Studies;
Semicircular Canals
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2021;56(12):1277-1282
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the characteristics of dynamic balance during the onset of benign paroxysmal positional vertigo (BPPV) and its prediction of residual symptoms after successful repositioning. Methods: From January 2018 to August 2019, patients diagnosed with unilateral posterior semicircular canal or horizontal semicircular canal BPPV were consecutively enrolled from five otolaryngology clinics in Shanghai. The dynamic balance function was measured by sensory organization test (SOT) before repositioning maneuver, and the residual symptoms and its duration were followed up from one week to up to three months. Results: A total of 260 patients were recruited. After excluding 17 cases, 243 cases were successfully followed up including 89 males and 154 females, with an average age of (52.9±13.0) years. There were 175 cases of posterior semicircular BPPV, 61 cases of horizontal semicircular BPPV and 7 cases of canal conversion (from horizontal to posterior semicircular). Among 243 patients, 118 cases reported residual symptoms, with an incidence of 48.6%. The results of SOT showed that 58.0%(141/243) of the patients had abnormal vestibular input and 41.6%(101/243) were categorized as "near falls". With respect to the detailed residual symptoms, 47 cases (39.8%) reported unsteadiness or floating, 35 cases (29.7%) had fogginess/heaviness feeling, 22 cases (18.6%) had transient dizzy while head moving, and 15 cases (12.7%) reported that the symptom was too subtle to describe. Compared with the group without residual symptoms, the group with residual symptoms had more abnormal vestibular input(χ²=67.25, P<0.001) and near falls(χ²=74.78, P<0.001) as identified by SOT test. Cox proportional hazards regression failed to reveal any SOT results having significantly impact on the duration of residual symptoms [abnormal vestibular input (HR= 0.93, 95%CI: 0.48, 1.80), and near falls (HR= 0.90, 95%CI: 0.56, 1.46)]. Kaplan-Meier survival analysis showed that there was no significant difference in the duration of residual symptoms among patients with different SOT manifestations [Log rank (Mantel-Cox) test, P>0.05]. Conclusions: The impaired dynamic balance during the onset of BPPV is characterized by "abnormal vestibular input". The residual symptoms are mainly characterized by unsteadiness or floating feeling. The defect of dynamic balance function is a predictor of the residual symptoms after successful repositioning, but not for the duration of such symptoms.
