Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine.
Department of Laboratory Medicine, Hallym University College of Medicine, Anyang.
Otol Neurotol. 2019 Feb;40(2):e135-e141. doi: 10.1097/MAO.0000000000002084.
To evaluate the association between benign paroxysmal positional vertigo (BPPV) and sudden sensorineural hearing loss (SSNHL) using a national sample cohort from Korea.
Data from the years 2002 through 2013 were collected for individuals aged more than or equal to 20 years from the Korean National Health Insurance Service-National Sample Cohort. SSNHL was classified based on the International Classification of Disease-10 (ICD-10) code H91.2. We included only participants who received an audiometry examination and steroid treatment. After exclusion of participants diagnosed with Menière's disease (H81.0), we extracted data for SSNHL patients (n = 4,109) and 1:4-matched controls (n = 16,436). Matching was performed based on age, sex, income, region of residence, and medical history. BPPV was diagnosed with the ICD-10 code H81.1. Among them, we only included the participants who visit more than or equal to two times for BPPV that does not mean recurrent BPPV. The crude and adjusted hazard ratios (HRs) were calculated using Cox proportional hazard models, and the 95% confidence intervals (CIs) were determined. Subgroup analyses were also performed according to age and sex.
The rate of BPPV in the SSNHL group (3.8% [157/4,109]) was higher than that in the control group (1.9% [220/16,436], p < 0.001). The adjusted HR of BPPV was 2.90 (95% CI = 2.36-3.56, p < 0.05). After experiencing SSNHL, the rate of BPPV in the SSNHL group was significantly higher for patients with two, three to four, and more than or equal to five visits for BPPV. In the subgroup analyses, a significant association between SSNHL and BPPV was observed regardless of age and sex.
The risk of BPPV is greater in patients with SSNHL.
利用来自韩国的全国样本队列评估良性阵发性位置性眩晕（BPPV）与突发性聋（SSNHL）之间的相关性。
我们从韩国国民健康保险服务-国家样本队列中收集了 2002 年至 2013 年期间年龄在 20 岁及以上人群的数据。SSNHL 基于疾病国际分类第 10 版（ICD-10）代码 H91.2 进行分类。我们仅纳入接受听力检查和类固醇治疗的参与者。排除被诊断为梅尼埃病（H81.0）的参与者后，我们提取了 4109 例 SSNHL 患者和 16436 例 1:4 匹配对照者的数据。匹配基于年龄、性别、收入、居住地区和病史。BPPV 通过 ICD-10 代码 H81.1 进行诊断。其中，我们仅纳入因 BPPV 就诊超过 2 次的参与者，且这不意味着复发性 BPPV。使用 Cox 比例风险模型计算了未经调整和调整后的危险比（HR）及其 95%置信区间（CI）。还根据年龄和性别进行了亚组分析。
SSNHL 组中 BPPV 的发生率（3.8%[157/4109]）高于对照组（1.9%[220/16436]，p<0.001）。BPPV 的调整 HR 为 2.90（95%CI=2.36-3.56，p<0.05）。在经历 SSNHL 后，BPPV 就诊次数为 2 次、3-4 次和≥5 次的 SSNHL 组患者中 BPPV 的发生率显著更高。在亚组分析中，无论年龄和性别如何，SSNHL 与 BPPV 之间均存在显著相关性。
SSNHL 患者发生 BPPV 的风险更高。
