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Delayed Positional Vertigo after Stapes Surgery
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Jin Woo Park, Joon Hee Lee, Mee Hyun Song, Dae Bo Shim
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Res Vestib Sci. 2015;14(4):147-151.
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 Abstract
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- Postoperative vertigo can occur after stapes surgery in approximately 5% of the
patients, which more commonly presents immediately after surgery rather than
in the delayed period. Isolated delayed vertigo after stapes surgery is commonly
related to perilymphatic fistula. Herein we report a 36-year-old female patient
who developed positional vertigo 18 days after stapes surgery demonstrating severe
geotropic horizontal positional nystagmus on both sides during supine roll test.
This patient was eventually diagnosed as the horizontal semicircular canal benign
paroxysmal positional vertigo (BPPV) on the left side. This is a rare case of
delayed vertigo following stapes surgery caused by BPPV rather than perilymphatic
fistula.
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Clinical Characteristics of Horizontal Canal Benign Paroxysmal Positional
Vertigo with Persistent Geotropic Direction Changing Positional
Nystagmus
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Kyung Min Ko, Mee Hyun Song, Jin Woo Park, Joon Hee Lee, Yong Gook Shin, Dae Bo Shim
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Res Vestib Sci. 2015;14(4):117-122.
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Abstract
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- Objective: The purpose of this study was to identify the clinical characteristics of
horizontal canal benign paroxysmal positional vertigo (h-BPPV) with persistent geotropic
direction changing positional nystagmus (DCPN).
Methods
One hundred thirty two patients diagnosed as the geotropic subtype of
h-BPPV were analyzed retrospectively. Patients were classified into two groups:
persistent h-BPPV (ph-BPPV) group which means h-BPPV showing persistent (＞1
minute) geotropic DCPN and short duration h-BPPV (sh-BPPV) group that means
h-BPPV with short duration (≤1 minute) geotropic DCPN. We compared the clinical
characteristics and treatment outcomes between the two groups.
Results
The study included 34 patients with ph-BPPV and 98 patients with sh-BPPV.
There were no differences between the two groups in age, distribution of sex and the
affected side. The ph-BPPV group had higher secondary BPPV preponderance and
dizziness handicap index (DHI) score compared to the sh-BPPV group. The ph-BPPV
group required higher number of canalith repositioning procedures (CRPs) until
resolution and higher multiple/single CRP ratio than the sh-BPPV group. In addition,
the ph-BPPV group showed longer duration until the remission of subjective symptoms
(vertigo, dizziness) compared to the sh-BPPV group.
Conclusion
ph-BPPV was more frequently associated with secondary causes of BPPV
and demonstrated higher DHI score, total number of CRP, and longer remission
duration of subjective symptoms compared to sh-BPPV. This information may be
helpful for clinicians in counseling and managing the patients with persistent geotropic
DCPN h-BPPV.
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KBS
