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单侧特发性良性阵发性位置性眩晕患者的骨密度分析及双温试验结果。

Analysis of Bone Mineral Density and Bithermal Caloric Test Results in Unilateral Idiopathic Benign Paroxysmal Positional Vertigo Patients.

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University.

Department of Otorhinolaryngology-Head and Neck Surgery, Shulan (Hangzhou) Hospital, International Medical College of Zhejiang Shuren University, Hangzhou, China.

出版信息

Otol Neurotol. 2022 Aug 1;43(7):e780-e786. doi: 10.1097/MAO.0000000000003565. Epub 2022 Jun 29.

Abstract

OBJECTIVE

Benign paroxysmal positional vertigo (BPPV) is the most frequently diagnosed type of peripheral vestibular vertigo. Studies have reported a possible association between BPPV and osteoporosis; however, there is still a lack of evidence. This study aimed to investigate the characteristics of bone mineral density (BMD) and bithermal caloric test results in patients with unilateral posterior canal idiopathic benign paroxysmal positional vertigo (pc-iBPPV).

METHODS

BMD was measured in 65pc-iBPPV menopausal female patients and 65 healthy controls using dual-energy xray absorptiometry and then compared the T-score of BMD between the two groups. The bithermal caloric test was also performed with video nystagmography and the relationship between canal paresis, directional preponderance, T-score, and recurrence were analyzed.

RESULTS

Lower T-scores were observed in pc-iBPPV patients compared with the normal subjects. Among 65 pc-iBPPV patients, free recurrence was observed in 38 (58.5%), single recurrence was noted in 14 (21.5%), and multiple recurrences were seen in 13 (20%) patients. The proportion of positive T-score and CP value increased with the pc-BPPV recurrence frequency. Statistically, a significant difference was found only in T-score, indicating that recurrence was raised with a decrement of T-score. The proportion of positive CP values tended to increase as BMD decreased.

CONCLUSION

The decrement of BMD might be one of the pathogeneses in patients with unilateral pc-iBPPV and associated with multiple recurrences. Moreover, positive CP value cannot be regarded as a predictive factor for recurrence; however, there is a clear association between CP and BMD.

摘要

目的

良性阵发性位置性眩晕(BPPV)是最常见的外周性前庭性眩晕诊断类型。有研究报道 BPPV 与骨质疏松之间可能存在关联,但目前仍缺乏证据。本研究旨在探讨单侧后半规管特发性良性阵发性位置性眩晕(pc-iBPPV)患者的骨密度(BMD)和双温冷热试验结果的特征。

方法

采用双能 X 射线吸收仪测量 65 例绝经后女性 pc-iBPPV 患者和 65 例健康对照者的 BMD,并比较两组间 BMD 的 T 评分。同时进行双温冷热试验,结合视频眼震图分析管麻痹、优势偏向、T 评分与复发之间的关系。

结果

pc-iBPPV 患者的 T 评分低于正常对照组。65 例 pc-iBPPV 患者中,自由复发 38 例(58.5%),单发性复发 14 例(21.5%),多发性复发 13 例(20%)。阳性 T 评分和 CP 值的比例随着 pc-BPPV 复发频率的增加而增加。统计学上,仅 T 评分存在显著差异,表明随着 T 评分的降低,复发率增加。CP 值阳性的比例随着 BMD 的降低而有增加的趋势。

结论

BMD 的降低可能是单侧 pc-iBPPV 患者的发病机制之一,与多次复发有关。此外,CP 值阳性不能作为复发的预测因素,但 CP 值与 BMD 之间存在明显的关联。

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