Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2022, Vol. 36 ›› Issue (4): 108-113.doi: 10.6040/j.issn.1673-3770.0.2021.445

Previous Articles    

Research progress on the pathogenesis and clinical characteristics of BPPV secondary to inner ear diseases

HUANG Lan1, GAO Wei2Overview,CHEN Ganggang2Guidance   

  1. 1. Shanxi Medical University, Taiyuan 030001, Shanxi, China;
    2. Department of Otorhinolaryngology & Head and Neck Surgery, the first Hospital of Shanxi Medical University/Shanxi key Laboratory of Otorhinolaryngology/Institute of Otorhinolaryngology, Shanxi Medical University, Taiyuan 030001, Shanxi, China
  • Published:2022-07-11

PDF (PC)

160

Abstract: Benign paroxysmal positional vertigo(BPPV)is one of the most common peripheral vestibular dysfunction diseases, which can be divided into idiopathic and secondary BPPV. Exogenous disease is considered to be the most important risk factor for secondary BPPV. In addition to history of ear trauma and inner ear surgery, common inner ear diseases, including Meniere's disease, sudden sensorineural hearing loss, vestibular neuritis, and vestibular migraine, may also result in secondary BPPV. Moreover, secondary BPPV can occur at any stage of inner ear disease with similar clinical manifestations. Therefore, this paper aimed to systematically review relevant national and international literature, as well as summarize and analyze the pathogenesis and clinical characteristics of BPPV secondary to common inner ear diseases, as a reference for clinical diagnosis and treatment.

Key words: Inner ear diseases, Secondary BPPV, Meniere's disease, Sudden sensorineural hearing loss, Vestibular neuriti, Vestibular migraine

CLC Number: 

  • R764.3
[1] von Brevern M, Radtke A, Lezius F, et al. Epidemiology of benign paroxysmal positional Vertigo: a population based study[J]. J Neurol Neurosurg Psychiatry, 2007, 78(7): 710-715. doi:10.1136/jnnp.2006.100420.
[2] Cohen HS. New epidemiological findings on benign paroxysmal positional Vertigo[J]. J Neurol Neurosurg Psychiatry, 2007, 78(7): 663. doi:10.1136/jnnp.2006.109447.
[3] Karlberg M, Hall K, Quickert N, et al. What inner ear diseases cause benign paroxysmal positional vertigo? [J]. Acta Otolaryngol, 2000, 120(3): 380-385. doi:10.1080/000164800750000603.
[4] Caldas MA, Ganança CF, Ganança FF, et al. Clinical features of benign paroxysmal positional Vertigo[J]. Braz J Otorhinolaryngol, 2009, 75(4): 502-506.
[5] 罗阳, 范罡, 张晓莉, 等. 原发性与继发性良性位置性眩晕诊治分析[J]. 中国实用神经疾病杂志, 2015, 18(24): 100-101. doi:10.3969/j.issn.1673-5110.2015.24.068.
[6] 赵鹏鹏, 徐先荣, 金占国, 等. 继发性良性阵发性位置性眩晕的临床特征分析[J]. 临床耳鼻咽喉头颈外科杂志, 2019, 33(3): 220-224. doi:10.13201/j.issn.1001-1781.2019.03.009. ZHAO Pengpeng, XU Xianrong, JIN Zhanguo, et al. Analysis of clinical features of secondary benign paroxysmal positional Vertigo[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2019, 33(3): 220-224. doi:10.13201/j.issn.1001-1781.2019.03.009.
[7] 曹莉梅, 蒋宾, 廖远高. 良性阵发性位置性眩晕患者临床特征和危险因素分析[J]. 临床耳鼻咽喉头颈外科杂志, 2021, 35(10): 905-909. doi:10.13201/j.issn.2096-7993.2021.10.009. CAO Limei, JIANG Bin, LIAO Yuangao. Analysis of clinical characteristics and risk factors in patients with benign paroxysmal positional Vertigo[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2021, 35(10): 905-909. doi:10.13201/j.issn.2096-7993.2021.10.009.
[8] Sfakianaki I, Binos P, Karkos P, et al. Risk factors for recurrence of benign paroxysmal positional Vertigo. A clinical review[J]. J Clin Med, 2021, 10(19): 4372. doi:10.3390/jcm10194372.
[9] 吴子明, 张素珍, 刘兴健, 等. 内耳病变并发良性阵发性位置性眩晕[J]. 中华耳鼻咽喉头颈外科杂志, 2007, 42(11): 821-825. WU Ziming, ZHANG Suzhen, LIU Xingjian, et al. Benign paroxysmal positioning Vertigo related to inner ear disorders[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2007, 42(11): 821-825.
[10] 崔程敏, 闫亚平, 张淑香. 原发性和继发性良性阵发性位置性眩晕临床特征分析[J]. 北京医学, 2018, 40(8): 742-744. doi:10.15932/j.0253-9713.2018.08.006. CUI Chengmin, YAN Yaping, ZHANG Shuxiang. Clinical characteristics of primary and secondary benign paroxysmal positional Vertigo[J]. Beijing Medical Journal, 2018, 40(8): 742-744. doi:10.15932/j.0253-9713.2018.08.006.
[11] Luryi AL, Lawrence J, Bojrab D, et al. Patient, disease, and outcome characteristics of benign paroxysmal positional Vertigo with and without Meniere's disease[J]. Acta Otolaryngol, 2018, 138(10): 893-897. doi:10.1080/00016489.2018.1484566.
[12] 朱美婵, 周枫, 谭国杰, 等. 并发梅尼埃病的管结石症良性阵发性位置性眩晕临床特点分析[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(20): 1615-1619. doi:10.13201/j.issn.1001-1781.2016.20.009. ZHU Meichan, ZHOU Feng, TAN Guojie, et al. Clinical analysis of benign paroxysmal positional Vertigo associated with Meniere's disease[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2016, 30(20): 1615-1619. doi:10.13201/j.issn.1001-1781.2016.20.009.
[13] Kutlubaev MA, Xu Y, Hornibrook J. Benign paroxysmal positional Vertigo in Meniere's disease: systematic review and meta-analysis of frequency and clinical characteristics[J]. J Neurol, 2021, 268(5): 1608-1614. doi:10.1007/s00415-019-09502-x.
[14] Hornibrook J. Saccular otoconia as a cause of Ménière's disease: hypothesis based on two theories[J]. J Laryngol Otol, 2018, 132(9): 771-774. doi:10.1017/S0022215118001366.
[15] Jahn AF. Benign positional Vertigo and endolymphatic Hydrops: what is the connection? [J]. J Laryngol Otol, 2017, 131(8): 658-660. doi:10.1017/S002221511700130X.
[16] Chen JB, Zhang SL, Cui K, et al. Risk factors for benign paroxysmal positional Vertigo recurrence: a systematic review and meta-analysis[J]. J Neurol, 2021, 268(11): 4117-4127. doi:10.1007/s00415-020-10175-0.
[17] 王登元, 陈智斌, 王杪琳. 伴发梅尼埃病的良性阵发性位置性眩晕的临床特点[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 61-65. doi:10.6040./j.issn.1673-3770.0.2017.237. WANG Dengyuan, CHEN Zhibin, WANG Miaolin. An assessment of the clinical features of benign paroxysmal positional Vertigo associated with Meniere's disease[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(3): 61-65. doi:10.6040./j.issn.1673-3770.0.2017.237.
[18] Morita N, Cureoglu S, Nomiya S, et al. Potential cause of positional Vertigo in Ménière's disease[J]. Otol Neurotol, 2009, 30(7): 956-960. doi:10.1097/MAO.0b013e3181b24368.
[19] Davcheva-Chakar M, Kopacheva-Barsova G, Nikolovski N. Simultaneous presentation of benign paroxysmal positional Vertigo and Meniere's disease- case report[J]. Open Access Maced J Med Sci, 2019, 7(21): 3626-3629. doi:10.3889/oamjms.2019.600.
[20] Gacek RR. Ménière's disease is a viral neuropathy[J]. ORL J Otorhinolaryngol Relat Spec, 2009, 71(2): 78-86. doi:10.1159/000189783.
[21] Dix MR, Hallpike CS. The pathology symptomatology and diagnosis of certain common disorders of the vestibular system[J]. Proc R Soc Med, 1952, 45(6): 341-354.
[22] Yeti??塂er S. Co-existence of benign paroxysmal positional Vertigo and Meniere's syndrome[J]. J Int Adv Otol, 2017, 13(1): 65-68. doi:10.5152/iao.2016.2906.
[23] Gross EM, Ress BD, Viirre ES, et al. Intractable benign paroxysmal positional Vertigo in patients with Meniere's disease[J]. Laryngoscope, 2000, 110(4): 655-659. doi:10.1097/00005537-200004000-00022.
[24] Hong SM, Yeo SG. Clinical analysis of patients with idiopathic sudden sensorineural hearing loss and benign paroxysmal positional Vertigo[J]. Acta Otolaryngol, 2013, 133(5): 439-442. doi:10.3109/00016489.2012.754996.
[25] 曹海南, 宋玲玲, 蒋雯, 等. 继发于突发性聋的良性阵发性位置性眩晕的疗效分析[J]. 临床耳鼻咽喉头颈外科杂志, 2021, 35(3): 234-237. doi:10.13201/j.issn.2096-7993.2021.03.009. CAO Hainan, SONG Lingling, JIANG Wen, et al. Effect analysis of benign paroxysmal positional Vertigo secondary to sudden sensorineural hearing loss[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2021, 35(3): 234-237. doi:10.13201/j.issn.2096-7993.2021.03.009.
[26] Lee SY, Kong IG, Oh DJ, et al. Increased risk of benign paroxysmal positional Vertigo in patients with a history of sudden sensory neural hearing loss: a longitudinal follow-up study using a national sample cohort[J]. and, 2019, 40(2): e135-e141. doi:10.1097/MAO.0000000000002084.
[27] Kitterick PT, Smith SN, Lucas L. Hearing instruments for unilateral severe-to-profound sensorineural hearing loss in adults: a systematic review and meta-analysis[J]. Ear Hear, 2016, 37(5): 495-507. doi:10.1097/AUD.0000000000000313.
[28] Kim CH, Shin JE, Yang YS, et al. Sudden sensorineural hearing loss with positional Vertigo: initial findings of positional nystagmus and hearing outcomes[J]. Int J Audiol, 2016, 55(10): 541-546. doi:10.1080/14992027.2016.1194532.
[29] 冯娟娟, 程泽星, 沈永华. 突发性耳聋继发良性阵发性位置性眩晕的相关发病因素分析[J]. 中国医药导刊, 2017, 19(10): 1002-1005. doi:10.3969/j.issn.1009-0959.2017.10.009. FENG Juanjuan, CHENG Zexing, SHEN Yonghua. Analysis of related factors of benign paroxysmal positional Vertigo secondary to sudden deafness[J]. Chinese Journal of Medicinal Guide, 2017, 19(10): 1002-1005. doi:10.3969/j.issn.1009-0959.2017.10.009.
[30] 田从哲, 高永平, 孟胜环, 等. 继发于突发性聋的良性阵发性位置性眩晕8例临床分析[J]. 听力学及言语疾病杂志, 2015, 23(6): 657-658. doi:10.3969/j.issn.1006-7299.2015.06.022.
[31] Lee NH, Ban JH. Is BPPV a prognostic factor in idiopathic sudden sensory hearing loss? [J]. Clin Exp Otorhinolaryngol, 2010, 3(4): 199-202. doi:10.3342/ceo.2010.3.4.199.
[32] Kim MB, Ban JH. Benign paroxysmal positional Vertigo accompanied by sudden sensorineural hearing loss: a comparative study with idiopathic benign paroxysmal positional Vertigo[J]. Laryngoscope, 2012, 122(12): 2832-2836. doi:10.1002/lary.23607.
[33] Lundberg YW, Xu YF, Thiessen KD, et al. Mechanisms of otoconia and otolith development[J]. Dev Dyn, 2015, 244(3): 239-253. doi:10.1002/dvdy.24195.
[34] 龚桃根, 郑铨艺, 柯朝阳, 等. 突发性聋并发良性阵发性位置性眩晕的临床分析[J]. 中华耳科学杂志, 2018, 16(2): 171-175. doi:10.3969/j.issn.1672-2922.2018.02.009. GONG Taogen, ZHENG Quanyi, KE Chaoyang, et al. Patients with idiopathic sudden sensorineural hearing loss and comorbid benign paroxysmal positional Vertigo[J]. Chinese Journal of Otology, 2018, 16(2): 171-175. doi:10.3969/j.issn.1672-2922.2018.02.009.
[35] Kim YH, Kim KS, Choi H, et al. Benign paroxysmal positional Vertigo is not a prognostic factor in sudden sensorineural hearing loss[J]. Otolaryngol Head Neck Surg, 2012, 146(2): 279-282. doi:10.1177/0194599811421733.
[36] Edlow JA, Newman-Toker D. Using the physical examination to diagnose patients with acute dizziness and Vertigo[J]. J Emerg Med, 2016, 50(4): 617-628. doi:10.1016/j.jemermed.2015.10.040.
[37] Sahin C, Varim C, Uyanik M, et al. The usefulness of monitoring the neutrophil to lymphocyte ratio in patients with peripheral Vertigo[J]. Georgian Med News, 2016(256/257): 52-57.
[38] 严钢莉, 黎逢光, 李朝武, 等. 伴发良性阵发性位置性眩晕的急性前庭神经炎的临床特点分析[J]. 神经损伤与功能重建, 2018, 13(10): 505-507, 514. doi:10.16780/j.cnki.sjssgncj.2018.10.006. YAN Gangli, LI Fengguang, LI Chaowu, et al. Clinical characteristics of benign paroxysmal positional Vertigo in patients with vestibular neuritis[J]. Neural Injury and Functional Reconstruction, 2018, 13(10): 505-507, 514. doi:10.16780/j.cnki.sjssgncj.2018.10.006.
[39] Türk B, Akpinar M, Kaya KS, et al. Benign paroxysmal positional Vertigo: comparison of idiopathic BPPV and BPPV secondary to vestibular neuritis[J]. Ear Nose Throat J, 2021, 100(7): 532-535. doi:10.1177/0145561319871234.
[40] Kunel'skaya NL, Mokrysheva NG, Guseva AL, et al. Benign paroxysmal positional Vertigo: modern concepts of its etiology and pathogenesis[J]. Vestn Otorinolaringol, 2017, 82(3): 75-79. doi:10.17116/otorino201782375-79.
[41] West N, Hansen S, Bloch SL, et al. Benign paroxysmal positional vertigo treatment[J]. UgeskrLaeger, 2017, 179(23):V11160784.
[42] Kim SK, Hong SM, Park IS, et al. Association between migraine and benign paroxysmal positional Vertigo among adults in south Korea[J]. JAMA Otolaryngol Head Neck Surg, 2019, 145(4): 307-312. doi:10.1001/jamaoto.2018.4016.
[43] Sugaya N, Arai M, Goto F. Is the headache in patients with vestibular migraine attenuated by vestibular rehabilitation? [J]. Front Neurol, 2017, 8: 124. doi:10.3389/fneur.2017.00124.
[44] Güçlütürk MT, Ünal ZN, ismi O, et al. The role of oxidative stress and inflammatory mediators in benign paroxysmal positional Vertigo[J]. J Int Adv Otol, 2016, 12(1): 101-105. doi:10.5152/iao.2015.1412.
[45] Ciancarelli I, Tozzi-Ciancarelli MG, Spacca G, et al. Relationship between biofeedback and oxidative stress in patients with chronic migraine[J]. Cephalalgia, 2007, 27(10): 1136-1141. doi:10.1111/j.1468-2982.2007.01398.x.
[46] 欧阳汤鹏, 徐先荣, 翟丽红, 等. 前庭性偏头痛并发良性阵发性位置性眩晕临床特征分析[J]. 听力学及言语疾病杂志, 2021, 29(6): 604-608. doi:10.3969/j.issn.1006-7299.06.002. OUYANG Tangpeng, XU Xianrong, ZHAI Lihong, et al. Clinical analysis of benign paroxysmal positional Vertigo associated with vestibular migraine[J]. Journal of Audiology and Speech Pathology, 2021, 29(6): 604-608. doi:10.3969/j.issn.1006-7299.06.002.
[47] Zhu CT, Li YQ, Ju Y, et al. Dizziness handicap and anxiety depression among patients with benign paroxysmal positional Vertigo and vestibular migraine[J]. Medicine, 2020, 99(52): e23752. doi:10.1097/md.0000000000023752.
[48] 蒋子栋. 应重视良性阵发性位置性眩晕与前庭性偏头痛的鉴别[J]. 中华医学杂志, 2021, 101(37): 2925-2929. doi:10.3760/cma.j.cn112137-20210118-00157. JIANG Zidong. Attention should be paid to the differentiation between benign paroxysmal positional Vertigo and vestibular migraine[J]. National Medical Journal of China, 2021, 101(37): 2925-2929. doi:10.3760/cma.j.cn112137-20210118-00157.
[49] Mahrous MM. Vestibular migraine and benign paroxysmal positional Vertigo, close presentation dilemma[J]. Acta Otolaryngol, 2020, 140(9): 741-744. doi:10.1080/00016489.2020.1770857.
[1] TAN Yufang, YI Tianhua. Clinical characteristics and prognosis of sudden sensorineural hearing loss in post-irradiated nasopharyngeal carcinoma survivors: a report of 18 cases [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(1): 35-39.
[2] To analyze the clinical outcomes of patients with unilateral idiopathic sudden sensorineural hearing loss(SSNHL)and explore the relationship between vestibular function and prognosis in patients with SSNHL. MethodsA retrospective analysis of patients( ears)with SSNHL was performed. A total of vestibular function tests were performed in all patients to assess the influence of vestibular functions on the clinical outcome of SSNHL. ResultsTreatments were less effective in patients with abnormalities in ocular vestibular evoked myogenic potential(oVEMP)or cervical vestibular evoked myogenic potential(cVEMP). Those with normal oVEMP and cVEMP had relatively better hearing recovery. The outcomes of the caloric test or video head impulse test showed no association with the efficacy of treatment or hearing recovery in patients with SSNHL. Treatment was less effective in patients with abnormalities in both oVEMP and cVEMP, who also had worse hearing recovery than those who had an abnormal finding in only one of the two tests. ConclusionsPatients with abnormal oVEMP or cVEMP results had poor clinical outcomes, while those with normal oVEMP and cVEMP demonstrated better hearing recovery with treatment. Thus, oVEMP and cVEMP could be effective indices to predict the prognosis of patients with SSNHL. An abnormal vestibular function is a definite indicator of a wider and more severe pathological change in the inner ear of patients with SSNHL.. Clinical value of vestibular evoked myogenic potential to predict prognosis of unilateral idiopathic sudden sensorineural hearing loss [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 27-32.
[3] To analyze the relationship between vestibular symptoms and function and hearing outcomes in patients with unilateral profound sudden sensorineural hearing loss(SSNHL). MethodsA retrospective analysis of patients with unilateral profound SSNHL was performed. Vestibular symptoms and the results of ocular vestibular evoked myogenic potential(oVEMP), cervical vestibular evoked myogenic potential(cVEMP), video head impulse test(vHIT), and caloric test were analyzed to observe the relationship between hearing outcomes and vestibular symptoms and function. ResultsOf patients with unilateral profound SSNHL, there was a significant difference between the patients with and without vestibular symptoms, patients with vestibular dysfunction, and those with normal vestibular function. Patients with abnormal oVEMP, cVEMP, vHIT, and caloric test results showed a lower total effective rate. In contrast, patients with normal results in all four tests had a higher hearing recovery. ConclusionPatients with unilateral profound SSNHL with abnormal vestibular dysfunction and symptoms had a poor curative effect. Conversely, those with normal oVEMP, cVEMP, vHIT, and caloric test results had better chances of hearing recovery. Abnormal vestibular function suggests more extensive and severe inner ear lesions in patients with unilateral profound SSNHL.. Relationship between prognosis and vestibular symptoms/function in patients with unilateral profound sudden sensorineural hearing loss: A retrospective analysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 33-38.
[4] XU Ming, LUO Xinggu, TANG Hongbo, JIANG Qingshan. Clinical characteristics and prognostic factors for sudden idiopathic sensorineural hearing loss in children [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(5): 41-44.
[5] LIU Yangyun, ZHANG Caixia, JIANG Wen, CHEN Qiong, CHANG Enge, ZHAO Huaxiang, YAN Hui. Analysis of blood lipids in patients with sudden sensorineural hearing loss. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(6): 1-4.
[6] HENG Weiwei, HOU Jie, WEI Xianmei, SHE Wandong. Expressions and significance of TNF-α and IL-8 in serum and peripheral blood mononuclear cells from patients with sudden sensorineural hearing loss. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(2): 40-45.
[7] LU Na. Three different routes of administration in the treatment of sudden sensorineural hearing loss [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(2): 24-27.
[8] ZHANG Cai-xia, LIU Yang-yun, CHEN Zhi-xi, JIANG Wen, LI Zheng-xian, CHEN Qiong, CHANG En-ge. Time pattern of audiological recoverey with intratympanic steroid injection as primary treatment for sudden sensorineural hearing loss [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(1): 15-18.
[9] YAN Xiao-ling, MAO Min, ZHAI Jin-ming, CHEN Guan-gui, ZHANG Jian-guo, LIU Qi-ming, XUE Jin-ping. Intratympanic steroids to treat refractory sudden sensorineural hearing loss(52 cases report) [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2014, 28(5): 23-26.
[10] LIU Dong-mei1, XU Kai-lun1, LUO Xiao1, et al. Short-term effectiveness of intratympanic plus intravenous Dexamethasone injection and conventional regimen for sudden sensorineural hearing loss [J]. J Otolaryngol Ophthalmol Shandong Univ, 2013, 27(1): 26-30.
[11] WU Yun-gang， LI Xiao-yu， PANG Tai-zhong， GAO Fu-ping， LI Shan， WANG Cai-hua， ZHANG Hui， HUANG Meng-meng. Intratympanic dexamethasone injections through pharyngotympanic tube for sudden sensorineural hearing loss [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2012, 26(1): 29-30.
[12] TONG Jun, CAI Xun-hua,CHEN Wen-wen . Terapeutic effects of sudden sensorineural hearing loss in old and young [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2007, 21(6): 530-532 .
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd