Research in Vestibular Science

Original Articles

Clinical Characteristics of Sudden Sensorineural Hearing Loss Accompanying Benign Paroxysmal Positional Vertigo: Sung Min Park, Bin Kwon, Sung Won Li, Seok Min Hong, Sung Kyun Kim; Res Vestib Sci. 2020;19(2):71-78. Published online June 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.2.71

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Objectives
Idiopathic unilateral sudden sensorineural hearing loss (SSNHL) with simultaneous benign paroxysmal vertigo (BPPV) is known to be associated with poor hearing recovery. We aimed to investigate clinical findings in patients with SSNHL with BPPV and analyze prognostic factors including presence of BPPV related to hearing outcome.
Methods
We retrospectively reviewed the electronic medical data of 14 patients with concurrent SSNHL and BPPV (combined group). We selected 52 patients without BPPV as a control group who have matched initial threshold of pure tone audiometry and age of each patient in the combined group. We evaluated clinical characteristics of all participants and compared hearing outcomes between the 2 groups. A multivariate logistic regression analysis was performed to investigate the factors related to hearing recovery.
Results
Initial mean pure tone audiometry (PTA) threshold of combined group was 90.36±26.2 dB. Posterior canal was most commonly involved (n=7, 50%), and 8 (57%) patients showed abnormal video head impulse test results. There was no significant difference between hearing recovery rates of combined and control group (p=0.237) and mean pure tone audiometry threshold changes were not significantly different between the 2 groups (p=0.942). Old age (≥60 years), high initial PTA threshold (＞90 dB), and obesity (body mass index ≥ 25 kg/m²) were poor prognostic predictors.
Conclusions
There was no difference between hearing outcomes of combined group and profound SSNHL only group. BPPV was not a significant prognostic factor of SSNHL patients.

Citations

Citations to this article as recorded by

Which Is More Important for the Prognosis of Sudden Sensorineural Hearing Loss with Vertigo, Canal Paresis or Benign Paroxysmal Positional Vertigo?
Yong-Hwi An, Hyun Joon Shim
Research in Vestibular Science.2021; 20(3): 101. CrossRef

Clinical Significance of Spontaneous Nystagmus in Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo: Jun Lee, Sehun Chang, Ho Yun Lee; Res Vestib Sci. 2018;17(1):18-22. Published online March 15, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.1.18

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Abstract PDF: Objectives
We aimed to assess the clinical significance of spontaneous nystagmus (SN) in horizontal semicircular canal benign paroxysmal positional vertigo (HC-BPPV).
Methods
Twenty-four patients who were diagnosed with HC-BPPV in Eulji University Hospital from January 2015 to December 2016 were recruited. Various bed-side examinations including SN in both sitting and supine position, head roll test, and bithermal caloric test were evaluated. The number of canalith repositioning maneuvers were counted in all patients.
Results
SN was observed in 18.2% of geotropic HC-BPPV and 38.5% of apogeotropic HC-BPPV, respectively. There was no significant difference between presence of SN and the direction of initial nystagmus (p=0.386, 2-tailed Fisher exact test). The mean number of otolith repositioning maneuvers in patients with SN was 3.29±1.799 and this was significantly higher than in patients without SN (1.76±0.831) (p=0.009). Although the mean number of repositioning maneuver in patients in apogeotropic HC-BPPV and SN (3.80±1.924) tended to be higher than those who were diagnosed with apogeotropic HC-BPPV without SN (1.88±1.991) (p=0.035), the post hoc analysis with Bonferroni correction revealed that it was not significant because it was higher than the adjusted p-value (p=0.017). The initial direction of nystagmus was changed into the opposite direction in 29.17% of patient. However, this change was not different according to presence of SN (p=0.374, 2-tailed Fisher exact test).
Conclusions
The presence of SN in HC-BPPV may be associated with lower treatment response. In particular, cautions are needed in patients with apogeotropic HC-BPPV.

What Is the Prognosis of Patients with Benign Paroxysmal Positional Vertigo in Sudden Sensorineural Hearing Loss?: Yewon Lee, Sungil Nam; Res Vestib Sci. 2017;16(4):113-118. Published online December 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.4.113

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Abstract PDF

Objectives
Vertigo is considered a poor prognostic factor in patients with sudden sensorineural hearing loss (SSNHL). Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo and may accompany SSNHL. However, whether BPPV is a poor prognostic factor remains controversial. We identified features of prognostic utility in patients with both SSNHL and BPPV. Methods: We retrospectively evaluated data on all patients diagnosed with SSNHL at Keimyung University Dongsan Medical Center between January 2011 and December 2015. We reviewed medical records, the results of vestibular function testing, and audiographic data. Results: Of the 524 idiopathic SSNHL patients, 20 (3.8%) were also diagnosed with unilateral BPPV. The average pure tone average (PTA) of those with both SSNHL and BPPV was higher than that of those without BPPV. Of the 471 patients with SSNHL only, 143 (30%) exhibited complete recovery. Of the 33 SSNHL patients with vertigo, 3 (9%) exhibited complete recovery, but only 3 (15%) of those with both SSNHL and BPPV exhibited complete recovery. Of the 20 patients with both SSNHL and BPPV, 15 had ipsilateral BPPV and 5 contralateral BPPV. Conclusions: Patients with BPPV had a higher average initial PTA score and poorer hearing recovery after treatment, than patients with SSNHL alone. Patients with contralateral BPPV had a somewhat better prognosis than those with ipsilateral BPPV, but statistical significance was not attained.

Citations

Citations to this article as recorded by

Which Is More Important for the Prognosis of Sudden Sensorineural Hearing Loss with Vertigo, Canal Paresis or Benign Paroxysmal Positional Vertigo?
Yong-Hwi An, Hyun Joon Shim
Research in Vestibular Science.2021; 20(3): 101. CrossRef

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