良性阵发性位置性眩晕复发的临床特征分析

李潇潇; 区永康; 唐小武; 陈玲; 刘鹏; 黄秋红; 郑亿庆

doi:10.13201/j.issn.1001-1781.2018.11.006

良性阵发性位置性眩晕复发的临床特征分析

- 1. 中山大学新华学院听力与言语科学系(广州, 510520);
- 2. 中山大学孙逸仙纪念医院耳鼻咽喉科中山大学听力与言语研究所
基金项目:
广东省科技计划项目（No：2014A020212097）

详细信息

通讯作者: 区永康,E-mail:ouyk@mail.sysu.edu.cn

中图分类号: R764.3

收稿日期: 2018-04-16

Clinical features of recurrences in benign paroxysmal positional vertigo

- 1. Department of Listening and Speech Science, Xinhua College of Sun Yat-sen University, Guangzhou, 510520, China;
- 2. Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Institute of Otolaryngology, Institute of Hearing and Speech of Sun Yat-sen University

More Information

Corresponding author: OU Yongkang, E-mail: ouyk@mail.sysu.edu.cn

Received Date: 16 April 2018

摘要

摘要: 目的：探讨良性阵发性位置性眩晕（BPPV）复发的临床特征及可能的相关因素。方法：将复位治疗后复发的80例BPPV患者分为青年组（21例）、中年组（25例）和老年组（34例），收集和总结3组年龄、性别、病理类型及半规管位置改变等临床资料，并对再次复位的疗效进行分析。结果：本研究中原发性BPPV患者62例（77.5%），继发性BPPV 18例（22.5%）。原诊与复发半规管均以外半规管和后半规管多见，二者差异无统计学意义（P>0.05）。复发位置为同一半规管的患者占48.75%，同耳侧不同管占21.25%、不同耳侧占30.00%。复发后治疗随访1个月，总治愈率高达96.25%，一次性复位成功率为56.25%。结论：BPPV复发患者的年龄、性别、类型以及发生半规管的位置等存在一定的临床特征，较长的复发病程及变化率较高的半规管位置均支持来源于新耳石的观点。
- 良性阵发性位置性眩晕 /
- 复发 /
- 临床特征
Abstract: Objective: To study the clinical features of patients with recurrent benign paroxysmal positional vertigo (BPPV) and to analyze potential related factors of recurrences. Method: Eighty patients who suffered recurrent BPPV were enrolled in this study. Patients were divided into three groups:young group (21 cases), middle-aged group (25 cases) and old-aged group (34 cases). The clinical data including age, gender, pathological pattern and canal type of BPPV were collected. We further analyzed the efficacy of repositioning treatment for recurrent BPPV. Result: In this study, there are 62 cases of primary BPPV(77.50%) and 18 cases of secondary BPPV(22.50%). In patients with recurrent BPPV, the laterior semicircular canal BPPV and posterior semicircular canals BPPV were the most common, and there was no differences on the aspects of age and gender in the two groups of patients with recurrent HSC BPPV and PSC BPPV (P>0.05). Compared with the primary diagnosis, we found that 48.75% cases relapsed in the same semicircular canals, 21.25% cases relapsed in other canals of the same ear, and 30.00% cases relapsed in a different ear. In this study, 96.25% patients with recurrent BPPV were cured in a month and one-time reset success rate was 56.25%.Conclusion: The age, gender, pathological pattern and canal type show certain clinical features of recurrent BPPV. The evidence of long term of recurrence course and high variability of problematic location support the approval opinion based on new otolith.
- benign paroxysmal positional vertigo /
- recurrence /
- clinical features

HTML全文

参考文献(17)

[1]	SU P, LIU Y C, LIN H C.Risk factors for the recurrence of post-semicircular canal benign paroxysmal positional vertigo after canalith repositioning[J].J Neurol, 2016, 263:45-51.
[2]	HILTON M P, PINDER D K.The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo[J].Cochrane Database Syst Rev, 2014, 8:CD003162.
[3]	夏菲, 王彦君, 王宁宇.高龄老年良性阵发性位置性眩晕的特点及手法复位治疗的注意事项[J].临床耳鼻咽喉头颈外科杂志, 2015, 29(1):12-16.
[4]	中国自然医学杂志编辑部.划分中老年人年龄的标准[J].中国自然医学杂志, 2001, 3(4):211-211.
[5]	中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会.良性阵发性位置性眩晕诊断和治疗指南(2017)[J].中华耳鼻咽喉头颈外科杂志, 2017, 52(3):173-177.
[6]	田永胜, 王淑珍, 刘颖, 等.特发性良性阵发性位置性眩晕复发特点分析[J].临床鼻咽喉头颈外科杂志, 2018, 32(2):118-121.
[7]	KIM S Y, HAN S H, KIM Y H, etal.Clinical features of recurrence and osteoporotic changes in benign paroxysmal positional vertigo[J].Auris Nasus Larynx, 2017, 44:156-161.
[8]	PÉREZ P, FRANCO V, CUESTA P, et al.Recurrence of benign paroxysmal positional vertigo[J].Otol Neurotol, 2012, 33:437-443.
[9]	翟秀云, 刘博, 张玉和, 等.良性阵发性位置性眩晕患者的骨密度研究与分析[J].临床耳鼻咽喉头颈外科杂志, 2016, 30(23):1865-1869.
[10]	GIACOMINI P G, NAPOLITANO B, ALESSANDRINI M, et al.Recurrent paroxysmal positional vertigo related to oral contraceptive treatment[J].Gynecol Endocrinol, 2006, 22:5-8.
[11]	VIBERT D, KOMPIS M, HAUSLER R.Benign paroxysmal positional vertigo in older women may be related to osteoporosis and osteopenia[J].Ann Otol Rhinol Laryngol, 2003, 112:885-889.
[12]	TALAAT H S, KABEL A M, KHALIEL L H, etal.Reduction of recurrence rate of benign paroxysmal positional vertigo by treatment of severe vitamin D deficiency[J].Auris Nasus Larynx, 2016, 43:237-241.
[13]	MOSTAFA B E, YOUSSEF T A, HAMAD A S.The necessity of post-maneuver postural restriction in treating benign paroxysmal positional vertigo:a meta analytic study[J].Eur Arch Otorhinolaryngol, 2013, 270:849-852.
[14]	OTSUKA K, SUZUKI M, SHIMIZU S, etal.Model experiments of otoconia stability after canalith repositioning procedure of BPPV[J].Acta Otolaryngol, 2010, 130:804-809.
[15]	LI S, TIAN L, HAN Z, et al.Impact of postmaneuver sleep position on recurrence of benign paroxysmal positional vertigo[J].PLoS One, 2013, 8:e83566.
[16]	HORII A, KITAHARA T, OSAKI Y, et al.Intractable benign paroxysmal positioning vertigo:long-term follow-up and inner ear abnormality detected by threedimensional magnetic resonance imaging[J].Otol Neurotol, 2010, 31:250-255.
[17]	LEE J D, PARK M K, LEE B D, et al.Abnormality of cervical vestibular-evoked myogenic potentials and ocular vestibular-evoked myogenic potentials in patients with recurrent benign paroxysmal postitional vertigo[J].Acta Otolaryngol, 2013, 133:150-153.