Department of Otorhinolaryngology Head and neck surgery, 71185Peking University People's Hospital, Beijing, China.
Ear Nose Throat J. 2022 Mar;101(3):NP112-NP134. doi: 10.1177/0145561320943362. Epub 2020 Aug 10.
Benign paroxysmal positional vertigo (BPPV) has a high recurrence rate, but the risk factor-associated recurrence are elusive.
Searches were performed in PubMed, Embase, Cochrane library, Web of science, Chinese National Knowledge Infrastructure, and Sino Med up to November 3, 2019. The effect size was analyzed by odds ratio and 95% CI. Data from eligible studies were meta-analyzed using Stata version 15.0.
Our search resulted in a total of 4076 hits. Twenty-four outcomes of sixty articles were included in the meta-analysis. Risk factors for the recurrence of BPPV included female gender, age (≥65years), hyperlipidemia, diabetes, hypertension, migraine, cervical spondylosis, osteopenia/osteoporosis, head trauma, otitis media, abnormal vestibular evoked myogenic potential, and long use of computers. No significant differences were found in side, type of the involved semicircular canals, smoking, alcohol consumption, stroke, ear surgery, duration of vertigo before treatment, the times of repositioning, Meniere disease, sleep disorders, hypercholesterolemia, and 25-hydroxy vitamin D.
These findings strengthen clinical awareness of early warning to identify patients with potential relapse risk of BPPV and clinicians should counsel patients regarding the importance of follow-up after diagnosis of BPPV.
良性阵发性位置性眩晕(BPPV)的复发率较高,但与风险因素相关的复发仍不明确。
检索 PubMed、Embase、Cochrane 图书馆、Web of Science、中国知网和 Sino Med 数据库,检索时限均为 2019 年 11 月 3 日。采用比值比(OR)及其 95%置信区间(CI)作为效应量进行分析。采用 Stata 15.0 软件进行数据合并分析。
共检索到 4076 篇文献,最终纳入 60 篇文献中的 24 个结局指标进行 Meta 分析。BPPV 复发的危险因素包括女性、年龄(≥65 岁)、高脂血症、糖尿病、高血压、偏头痛、颈椎病、骨质疏松/骨量减少、头部外伤、中耳炎、前庭诱发肌源性电位异常、长期使用电脑。但 BPPV 侧别、受累半规管类型、吸烟、饮酒、脑卒中、耳部手术、眩晕持续时间、复位次数、梅尼埃病、睡眠障碍、高胆固醇血症和 25-羟维生素 D 等因素与 BPPV 复发无显著相关性。
这些发现增强了临床对识别 BPPV 潜在复发风险患者的意识,临床医生应在诊断 BPPV 后告知患者及时进行随访的重要性。