Kirbac Arzu, Turan Dizdar Handan, Kaya Ercan, Incesulu Saziye Armagan
Faculty of Health Sciences, Department of Audiology, Eskişehir Osmangazi University, Eskişehir, 26480, Turkey.
Faculty of Health Sciences, Department of Audiology, Samsun Ondokuz Mayıs University Kurupelit Campus, Samsun, Turkey.
Eur Arch Otorhinolaryngol. 2025 Jan;282(1):175-181. doi: 10.1007/s00405-024-08928-y. Epub 2024 Sep 4.
To determine the frequency and clinical features of new- and early-onset benign paroxysmal positional vertigo (BPPV) after different otologic surgical operations with and without surgical drilling.
All unilateral otologic operations performed at the otolaryngology clinic of a tertiary university hospital between January 2021 and May 2023 were screened, and 437 adult cases were included in the study. Of these patients, those who were diagnosed with BPPV within the first month postoperatively were examined.
The overall incidence of BPPV after otologic operations was 2.28% (10 out of 437 patients). This incidence was 3% (8/266 patients) in cases where a drill was used and 1.16% (2/171 patients) in those where a drill was not used. There was no significant difference between the two groups (p > 0.05). Clinical symptoms related to BPPV appeared on average in 13.3 ± 6.8 (range: 3-25) days following surgery and presented as canalolithiasis. All cases involved the posterior semicircular canal (SCC) on the operated side. In addition, one patient with a cochlear implant had involvement of both the posterior and lateral SCCs. All patients responded well to repositioning maneuvers during follow-up.
Otologic surgery, especially operations involving drilling, is a potential risk factor for the development of BPPV. Postoperative BPPV, primarily presenting as canalolithiasis in the posterior SCC on the operated side, can be effectively managed with repositioning maneuvers. Clinicians should be vigilant for BPPV in patients experiencing vertigo/dizziness within four weeks following otologic surgery.
确定在有或没有手术钻孔的不同耳科手术后新发和早发性良性阵发性位置性眩晕（BPPV）的发生率及临床特征。
筛选了2021年1月至2023年5月在一所三级大学医院耳鼻喉科诊所进行的所有单侧耳科手术，437例成年患者纳入研究。对这些患者中术后第一个月内被诊断为BPPV的患者进行检查。
耳科手术后BPPV的总体发生率为2.28%（437例患者中有10例）。使用钻孔的病例发生率为3%（266例患者中有8例），未使用钻孔的病例发生率为1.16%（171例患者中有2例）。两组之间无显著差异（p>0.05）。与BPPV相关的临床症状平均在术后13.3±6.8（范围：3 - 25）天出现，表现为管结石症。所有病例均累及手术侧的后半规管（SCC）。此外，1例人工耳蜗植入患者的后半规管和外半规管均受累。所有患者在随访期间对复位手法反应良好。
耳科手术，尤其是涉及钻孔的手术，是BPPV发生的潜在危险因素。术后BPPV主要表现为手术侧后半规管的管结石症，可通过复位手法有效治疗。临床医生应对耳科手术后四周内出现眩晕/头晕的患者警惕BPPV。
