Korres S G, Papadakis C E, Riga M G, Balatsouras D G, Dikeos D G, Soldatos C R
ENT Department of Hippokration Hospital, National University of Athens, Greece.
J Laryngol Otol. 2008 Dec;122(12):1295-8. doi: 10.1017/S0022215108002168. Epub 2008 Apr 3.
The aim of this study was to investigate the frequency of posterior semicircular canal benign paroxysmal positional vertigo in each ear, and to assess the association between the ear affected by benign paroxysmal positional vertigo and the head-lying side during sleep onset. Based on a previous study which used objective methods to prove the preference of the elderly for the right head-lying side during sleep, we hypothesised that a predominance of the same head-lying side in benign paroxysmal positional vertigo patients may affect the pathophysiology of otoconia displacement.
We conducted a prospective study of out-patients with posterior semicircular canal benign paroxysmal positional vertigo, confirmed by a positive Dix-Hallpike test.
One hundred and forty-two patients with posterior semicircular canal benign paroxysmal positional vertigo were interviewed about their past medical history, focusing on factors predisposing to benign paroxysmal positional vertigo. All patients included in the study were able to define a predominant, favourite head-lying side, right or left, during sleep onset.
The Dix-Hallpike test was found to be positive on the right side in 82 patients and positive on the left side in 54; six patients were found to be positive bilaterally. During sleep onset, 97 patients habitually laid their head on the right side and the remaining 45 laid their head on the left. The association between the affected ear and the head-lying side during sleep onset was statistically significant (p < 0.001).
Our study found a predominance of right-sided benign paroxysmal positional vertigo, a subjective preference amongst patients for a right head-lying position during sleep onset, and an association between the ear affected by benign paroxysmal positional vertigo and the preferred head-lying side during sleep onset. The clinical and therapeutical implications of this observation are discussed.
本研究旨在调查每侧耳朵后半规管良性阵发性位置性眩晕的发生率，并评估良性阵发性位置性眩晕受累耳与入睡时头部卧位之间的关联。基于先前一项使用客观方法证明老年人在睡眠时偏好右侧卧位的研究，我们假设良性阵发性位置性眩晕患者中同一卧位占优势可能会影响耳石移位的病理生理学。
我们对经Dix-Hallpike试验阳性确诊的后半规管良性阵发性位置性眩晕门诊患者进行了一项前瞻性研究。
对142例后半规管良性阵发性位置性眩晕患者进行了病史访谈，重点关注易患良性阵发性位置性眩晕的因素。纳入研究的所有患者都能够确定入睡时占优势的、偏好的卧位，右侧或左侧。
发现82例患者的Dix-Hallpike试验右侧阳性，54例左侧阳性；6例患者双侧阳性。入睡时，97例患者习惯性地将头偏向右侧，其余45例将头偏向左侧。受累耳与入睡时头部卧位之间的关联具有统计学意义（p < 0.001）。
我们的研究发现右侧良性阵发性位置性眩晕占优势，患者在入睡时主观上偏好右侧卧位，以及良性阵发性位置性眩晕受累耳与入睡时偏好的头部卧位之间存在关联。本文讨论了这一观察结果的临床和治疗意义。
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