Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
Department of Audiology, Rehabilitation Research Centre, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
Eur Arch Otorhinolaryngol. 2016 Mar;273(3):643-8. doi: 10.1007/s00405-015-3612-y. Epub 2015 Apr 1.
The presence of utricular and saccular dysfunction impairs quality of life (QoL) in patients. The aims of the present study were to examine the effect of repositioning maneuvers on QoL of patients with idiopathic benign paroxysmal positional vertigo (BPPV) and to describe the effect of cervical vestibular-evoked myogenic potential (cVEMP) or ocular VEMP (oVEMP) abnormalities on patient recovery after rehabilitation. Thirty idiopathic BPPV patients with/without otolith dysfunctions (n = 15, each group) were included in this clinical trial study. Otolith dysfunction was determined using oVEMP and cVEMP abnormalities. EcochG and caloric tests were performed to rule out other causes of secondary BPPV. The QoL in groups of patients with idiopathic BPPV was assessed using a Persian version of the dizziness handicap inventory (DHI-P) before and after treatment with Epley's maneuver. Pre-treatment results showed significant handicaps in both groups. DHI-P scores were higher in BPPV patients with otolith dysfunction (total, functional, emotional, physical score: 34.13, 11.20, 7.06, 15.86, respectively) than those in patients without otolith dysfunction (total, functional, emotional, physical score: 25.46, 7.86, 6.13, 11.46, respectively, P < 0.05). After treatment, DHI-P scores decreased in both groups. However, in the otolith dysfunction group, DHI-P scores (total, functional, emotional, physical score: 9.20, 3.33, 1.33, 4.53, respectively) were higher than those in patients without otolith dysfunction (total, functional, emotional, physical score: 4.13, 0.93, 1.06, 2.00, respectively). In BPPV patients with cVEMP or oVEMP abnormalities, QoL is more compromised in comparison with that in BPPV patients without these dysfunctions. Otolith dysfunction enhances the negative effects of BPPV on QoL.
前庭功能障碍会影响患者的生活质量（QoL）。本研究旨在探讨变位疗法对特发性良性阵发性位置性眩晕（BPPV）患者 QoL 的影响，并描述颈性前庭诱发肌源性电位（cVEMP）或眼性前庭诱发肌源性电位（oVEMP）异常对康复后患者恢复的影响。本临床试验研究纳入了 30 例特发性 BPPV 伴/不伴耳石功能障碍患者（n=15，每组）。通过 oVEMP 和 cVEMP 异常确定耳石功能障碍。进行耳声发射和冷热试验以排除继发性 BPPV 的其他原因。采用伊朗语版眩晕障碍量表（DHI-P）在 Epley 复位治疗前后评估特发性 BPPV 患者的 QoL。治疗前，两组患者均有明显的功能障碍。BPPV 伴耳石功能障碍患者（总、功能、情绪、躯体评分分别为 34.13、11.20、7.06、15.86）的 DHI-P 评分高于无耳石功能障碍患者（总、功能、情绪、躯体评分分别为 25.46、7.86、6.13、11.46，P＜0.05）。治疗后，两组患者的 DHI-P 评分均降低，但耳石功能障碍组的 DHI-P 评分（总、功能、情绪、躯体评分分别为 9.20、3.33、1.33、4.53）高于无耳石功能障碍患者（总、功能、情绪、躯体评分分别为 4.13、0.93、1.06、2.00）。BPPV 患者伴 cVEMP 或 oVEMP 异常时，其 QoL 较无此类功能障碍的患者更差。耳石功能障碍增强了 BPPV 对 QoL 的负面影响。
