Zhang Jing, Guo Ying, Zhang Jiao, Su Juan, Wang Mingxin, Zhang Geng, Zhou Huifang, Wang Qiuju
Otolaryngology of Tianjin Medical University General Hospital，Tianjin，300052，China.
Department of Audiology and Vestibular Medicine，Senior Department of Otolaryngology Head and Neck Surgery，the Sixth Medical Center of Chinese PLA General Hospital.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Mar;39(3):243-249. doi: 10.13201/j.issn.2096-7993.2025.03.011.
To explore relevant factors to accurately diagnose BPPV in vertigo children. A retrospective study was conducted on the proportion of BPPV in children（<18 years） with vertigo who visited the Hearing and Vertigo Diagnosis and Treatment Center of Tianjin Medical University General Hospital from September 2017 to August 2023. The clinical characteristics of BPPV children, including general demographics, medical history, first visit department, comorbidities, canal involvement, response to treatment, and incidence of recurrence, were analyzed. Data analysis was conducted using SPSS 25.0 software. BPPV was diagnosed in 22.8% of patients seen for vertigo during the study period. There are differences in the proportion of BPPV diagnosis among children with dizziness in different age groups（<0.05）, and the diagnosis of BPPV in the 7-12-year-old group has a longer disease course than in the 13-17-year-old group（<0.05）. 72.3%（47/65） of patients or their families were able to provide a typical history of positional vertigo. 49.2%（32/65） of BPPV patients had comorbidities, and there were differences in the proportion of comorbidities among different age groups of BPPV patients（<0.05）. With the progress of study, the proportion of BPPV in children with vertigo has shown an upward trend, and the proportion of children with otolaryngology as the first diagnosis department has also increased（<0.05）. The proportion of horizontal semicircular canals in children with BPPV has increased. All BPPV patients underwent canalith repositioning maneuvers, with good treatment outcomes and a recurrence rate of 12.3%（8/65）. The recurrence rate in the group of BPPV patients with comorbidities was 21.9%, which was higher than that in the group without comorbidities（<0.05）. Childhood BPPV has clinical characteristics such as unclear medical history, high proportion of comorbidities, easy recurrence in BPPV children with comorbidities and high proportion of horizontal semicircular canal involvement. For children diagnosed with other vertigo diseases, do not ignore the BPPV diagnostic test. It is recommended to perform routine position tests on children with vertigo if conditions permit to reduce missed diagnosis of BPPV in children.
探讨准确诊断儿童眩晕性耳石症（BPPV）的相关因素。对2017年9月至2023年8月在天津医科大学总医院听力与眩晕诊疗中心就诊的18岁以下眩晕儿童中BPPV的比例进行回顾性研究。分析BPPV患儿的临床特征，包括一般人口统计学资料、病史、首诊科室、合并症、受累半规管、治疗反应及复发率等。采用SPSS 25.0软件进行数据分析。研究期间因眩晕就诊的患者中，22.8%被诊断为BPPV。不同年龄组头晕儿童的BPPV诊断比例存在差异（P<0.05），7-12岁组BPPV的病程较13-17岁组更长（P<0.05）。72.3%（47/65）的患者或其家属能够提供典型的位置性眩晕病史。49.2%（32/65）的BPPV患者有合并症，不同年龄组BPPV患者的合并症比例存在差异（P<0.05）。随着研究进展，眩晕儿童中BPPV的比例呈上升趋势，以耳鼻咽喉科为首诊科室的儿童比例也有所增加（P<0.05）。BPPV患儿中水平半规管受累比例增加。所有BPPV患者均接受了耳石复位手法治疗，治疗效果良好，复发率为12.3%（8/65）。有合并症的BPPV患者组复发率为21.9%，高于无合并症组（P<0.05）。儿童BPPV具有病史不清、合并症比例高、有合并症的BPPV患儿易复发及水平半规管受累比例高等临床特点。对于诊断为其他眩晕疾病的儿童，不要忽视BPPV诊断检查。建议在条件允许时对眩晕儿童进行常规位置试验，以减少儿童BPPV的漏诊。
