Shu F, Zhang H Z, Cai J Q, Xu M Q, Jiang S S
Department of Otolaryngology Head and Neck Surgery，Zhujiang Hospital，Southern Medical University，Guangzhou，510282，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Jan;34(1):79-82. doi: 10.13201/j.issn.1001-1781.2020.01.019.
To investigate the clinical characteristics and therapeutic effect of benign paroxysm positional vertigo（BPPV） secondary to middle ear surgery. A total of 1 126 patients who underwent tympanoplasty or radical mastoidectomy due to chronic suppurative otitis media and middle ear cholesteatoma in our hospital from January 2014 to December 2018 were collected. Clinical data of BPPV within 1 month after surgery were collected, The incidence, incidence side, involved semicircular canal, onset time, age of onset, and duration of operation of secondary BPPV after middle ear surgery were analyzed. All patients with secondary BPPV were treated by manual reduction, and the efficacy was evaluated 1 day, 1 week, and 1 month after reduction. 2.13% （24 cases） of patients had secondary BPPV after operation, among which 2 cases were parietal incidence. 18 cases were involved in posterior semicircular canals and 6 cases were horizontal semicircular canals. The onset time was 1-12 days after the operation, with an average of （3.29±2.44） days. The mean age of onset was （51.62±10.15） years old, and there was no statistically significant difference between the age of patients without BPPV after middle ear surgery （>0.05）. The average operating time was （97.29±14.78） minutes, showing no statistically significant difference compared with patients in the group without BPPV （>0.05）. Fourteen cases （58.3%） were cured and 10 cases were improved after 1 day evaluation. Evaluated 1 week after treatment, 19 cases （79.17%） were cured and 5 cases were improved. Evaluated 1 month after treatment, all patients were cured without recurrence. BPPV secondary to middle ear surgery often appears 3 days after surgery, and the posterior semicircular canal of the operative ear is most commonly involved. Age and operation duration have no significant influence on the incidence of BPPV, and satisfactory therapeutic effect can be obtained through manipulative reduction.
探讨中耳手术后继发良性阵发性位置性眩晕（BPPV）的临床特点及治疗效果。收集2014年1月至2018年12月在我院因慢性化脓性中耳炎及中耳胆脂瘤行鼓室成形术或乳突根治术的1126例患者。收集术后1个月内BPPV的临床资料，分析中耳手术后继发BPPV的发病率、发病侧、受累半规管、发病时间、发病年龄及手术时长。所有继发BPPV的患者均接受手法复位治疗，并在复位后1天、1周及1个月评估疗效。术后2.13%（24例）患者继发BPPV，其中2例为顶石症。18例累及后半规管，6例累及水平半规管。发病时间为术后1 - 12天，平均（3.29±2.44）天。平均发病年龄为（51.62±10.15）岁，与中耳手术后未发生BPPV的患者年龄相比，差异无统计学意义（>0.05）。平均手术时长为（97.29±14.78）分钟，与未发生BPPV组患者相比，差异无统计学意义（>0.05）。复位后1天评估，14例（58.3%）治愈，10例好转。治疗1周后评估，19例（79.17%）治愈，5例好转。治疗1个月后评估，所有患者均治愈无复发。中耳手术后继发BPPV常出现在术后3天，患侧后半规管最常受累。年龄及手术时长对BPPV发病率无显著影响，通过手法复位可获得满意的治疗效果。
