Prevalence and management of post-BPPV residual symptoms

• Published in: European archives of oto-rhino-laryngology 2018-06, Vol.275 (6), p.1429-1437
• Main Authors: Vaduva, Cristina, Estéban-Sánchez, Jonathan, Sanz-Fernández, Ricardo, Martín-Sanz, Eduardo
• Format: Article
• Language: English
• Subjects: Head and Neck Surgery; Medicine; Medicine & Public Health; Neurosurgery; Otology; Otorhinolaryngology
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-018-4980-x

Objectives To evaluate the prevalence and management of residual symptoms in recovered BPPV patients. Methods We performed a retrospective study on BPPV patients of any of the three semicircular canals. Exclusion criteria were multiple-canal BPPV, refractory BPPV, central nervous system pathologies or other vestibular diseases. Patients were treated with repositioning maneuvers until the vertigo disappeared and evaluated for symptoms of instability at 1 month after resolution. A dynamic computerized posturography was then performed on every patient complaining of residual instability. We analyzed demographic data, the affected semicircular canal, number of repositioning maneuvers, presence of anxiety disorders, and we correlated these variables with the presence of residual disequilibrium 1 month after vertigo resolution. Results We included 361 patients. Residual disequilibrium was found in 107 patients (29.6%) with no significant difference between the rates associated with the three semicircular canals ( p  = 0.73). The group who needed more than one repositioning maneuver (1 maneuver-229 patients, ≥ 2maneuvers-132 patients) showed a significantly higher prevalence of instability (17.9 vs. 50%; p