Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata (BiND), Sezione di Audiologia, Università degli Studi di Palermo, Via del Vespro 129, 90127, Palermo, Italy.
Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata (BiND), Sezione di Otorinolaringoiatria, Università degli Studi di Palermo, Via del Vespro 129, 90127, Palermo, Italy.
Eur Arch Otorhinolaryngol. 2024 Jan;281(1):163-170. doi: 10.1007/s00405-023-08119-1. Epub 2023 Jul 12.
Benign paroxysmal positional vertigo (BPPV) may be found in patients complaining of hearing disorders. The aim of our investigation was to describe audiological findings in BPPV patients, focusing on subjects with asymmetric hearing loss (AHL), to better understand whether otoconial displacement may occur preferentially in the worst hearing ear.
A prospective study was performed on 112 BPPV patients. We divided the sample into subjects who suffered from AHL (G1) and patients with did not (G2). Data regarding vestibular symptoms, tinnitus, migraine, antivertigo drug therapy, and vascular risk factors were collected.
Out of 30 AHL subjects, 83.33% of them were affected by sensorineural hearing loss (SNHL) in at least one ear, with a significant difference in the distribution of hearing loss type between groups (p = 0.0006). In 70% of cases, the ear affected by BPPV was the one with the worst hearing threshold (p = 0.02); threshold asymmetry predicted BPPV in the worst hearing ear (p = 0.03). The predictability depended neither on the hearing threshold gap between ears nor the severity of the hearing threshold in the worst ear (p > 0.05). No differences in vascular risk factors between groups were observed (p > 0.05). We evidenced a moderate correlation between age and hearing threshold (ρ = 0.43). Age did not result a predictive factor for residual dizziness or BPPV in the worst ear (p > 0.05).
Our study supports the likelihood of an otoconial displacement in the worse hearing ear in BPPV patients. Clinicians should start testing the worst hearing ear when managing AHL patients with suspected BPPV.
良性阵发性位置性眩晕（BPPV）可能发生在有听力障碍主诉的患者中。我们调查的目的是描述 BPPV 患者的听力发现，重点关注有不对称性听力损失（AHL）的患者，以更好地了解耳石是否可能优先在最差听力耳中移位。
对 112 例 BPPV 患者进行前瞻性研究。我们将样本分为 AHL 患者（G1）和无 AHL 患者（G2）。收集了前庭症状、耳鸣、偏头痛、抗晕动病药物治疗和血管危险因素的数据。
在 30 例 AHL 患者中，83.33%的患者至少有一侧存在感音神经性听力损失（SNHL），两组之间听力损失类型的分布存在显著差异（p=0.0006）。在 70%的情况下，受 BPPV 影响的耳是听力阈值最差的耳（p=0.02）；听力阈值的不对称性预测了最差听力耳中的 BPPV（p=0.03）。可预测性既不取决于两耳之间的听力阈值差距，也不取决于最差耳的听力阈值严重程度（p>0.05）。两组之间的血管危险因素无差异（p>0.05）。我们发现年龄与听力阈值之间存在中度相关性（ρ=0.43）。年龄不是残留头晕或最差耳 BPPV 的预测因素（p>0.05）。
我们的研究支持在 BPPV 患者中，耳石可能在最差听力耳中移位的可能性。当管理疑似 BPPV 的 AHL 患者时，临床医生应首先测试最差听力耳。
