Atacan E, Sennaroglu L, Genc A, Kaya S
Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Medical Faculty, Ankara, Turkey.
Laryngoscope. 2001 Jul;111(7):1257-9. doi: 10.1097/00005537-200107000-00021.
To determine the incidence of benign paroxysmal positional vertigo (BPPV) following stapedectomy in a patient group and the efficacy of the Epley maneuver in this group.
Prospective study in a university-based tertiary referral system.
The patient group comprised 63 patients who had undergone stapedectomy; a control group consisted of normal healthy individuals with no otolaryngological complaints. All individuals underwent the Dix-Hallpike maneuver for the diagnosis of BPPV. Patients who exhibited vertigo, torsional nystagmus (which reverses its direction on return to sitting position) preceded by a latent period, and the fatigability of these findings were considered to have BPPV. If the test result was positive, they underwent the Epley therapeutic maneuver.
Four of the patients who had undergone a stapedectomy showed characteristic findings of BPPV. No individual in the control group had BPPV. All patients responded well to the Epley maneuver.
Stapedectomy may be regarded as an etiological factor in BPPV. Because the fenestra is located in the posterior part of the stapes footplate, the pathophysiology appears to be related to utricular rather than saccular trauma. Correct measurement of the distance between the incus and stapes footplate is essential in stapedectomy. An Internet survey of the relevant literature in English shows a scarcity of publications on the incidence of BPPV following stapedectomy. In the present study, 63 patients who had undergone a stapedectomy were investigated for the presence of BPPV; all had Dix-Hallpike maneuvers performed for the diagnosis. Sixty-three individuals with no otolaryngological complaints made up the control group. Four of the patients who had undergone stapedectomy showed characteristic findings of BPPV, and no individual in the control group had BPPV; the difference between the two groups was statistically significant. All four of the patients diagnosed with BPPV responded well to the Epley maneuver. The pathophysiology appears to be related to utricular trauma. Correct measurement of the distance between the incus and stapes footplate is essential in stapedectomy.
确定一组患者在镫骨切除术后良性阵发性位置性眩晕（BPPV）的发生率以及Epley手法对该组患者的疗效。
在以大学为基础的三级转诊系统中进行的前瞻性研究。
患者组包括63例行镫骨切除术的患者；对照组由无耳鼻喉科主诉的正常健康个体组成。所有个体均接受Dix-Hallpike手法以诊断BPPV。出现眩晕、潜伏期后扭转性眼球震颤（回到坐位时方向反转）且这些表现具有疲劳性的患者被认为患有BPPV。如果测试结果为阳性，则接受Epley治疗手法。
63例行镫骨切除术的患者中有4例表现出BPPV的特征性表现。对照组中无个体患有BPPV。所有患者对Epley手法反应良好。
镫骨切除术可被视为BPPV的一个病因。由于开窗位于镫骨底板后部，其病理生理学似乎与椭圆囊而非球囊损伤有关。在镫骨切除术中正确测量砧骨与镫骨底板之间的距离至关重要。一项对相关英文文献的互联网调查显示，关于镫骨切除术后BPPV发生率的出版物较少。在本研究中，对63例行镫骨切除术的患者进行了BPPV检查；所有患者均接受Dix-Hallpike手法以进行诊断。63名无耳鼻喉科主诉的个体组成对照组。63例行镫骨切除术的患者中有4例表现出BPPV的特征性表现，对照组中无个体患有BPPV；两组之间的差异具有统计学意义。所有4例被诊断为BPPV的患者对Epley手法反应良好。其病理生理学似乎与椭圆囊损伤有关。在镫骨切除术中正确测量砧骨与镫骨底板之间的距离至关重要。
