Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Japan.
Medicine Based Town Research Center, Nara Medical University, Kashihara, Japan.
J Int Adv Otol. 2024 Jan;20(1):76-80. doi: 10.5152/iao.2024.231181.
Vestibular frailty and presbyvestibulopathy, including benign paroxysmal positional vertigo (BPPV), can cause dizziness among elderly patients. Vestibular frailty and presbyvestibulopathy may contribute to the onset of the vicious circle of falling-bone fracture-prolonged bedridden status-senile dementia. Treatment interventions for vestibular frailty and presbyvestibulopathy should be based on vestibular rehabilitation rather than vestibular implantation or regeneration. In acute BPPV, the otolith repositioning maneuver can be used to return otolithic debris to the utricle. At the chronic remission stage, there are nutritional guidelines for improving bone density in otolith organs and rehabilitation guidelines for activating otolith organs to prevent exfoliation. Moreover, sleeping in the head-up position can prevent free-floating debris from entering the semicircular canal. Throughout their old age, the psychiatric care/support is also indispensable to keep their initiative against vestibular frailty.
前庭脆弱和前庭预衰老症,包括良性阵发性位置性眩晕(BPPV),可能会导致老年患者头晕。前庭脆弱和前庭预衰老症可能导致跌倒-骨折-长期卧床不起-老年痴呆的恶性循环的发生。针对前庭脆弱和前庭预衰老症的治疗干预应基于前庭康复,而不是前庭植入或再生。在急性 BPPV 中,可以使用耳石复位手法将耳石碎片返回耳石器。在慢性缓解期,有改善耳石器官骨密度的营养指南和激活耳石器官以防止脱落的康复指南。此外,头部抬高睡眠可以防止游离的耳石碎片进入半规管。在整个老年期间,精神科护理/支持也是必不可少的,可以保持他们对抗前庭脆弱的积极性。