Alshehri Sarah, Al Ahmree Abdullah Oudah, Qobty Abdulaziz, Musleh Abdullah, Alahmari Khalid A
Otolaryngology, Head and Neck Surgery, Department of Surgery, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia.
Armed Forces Hospital, Abha 62413, Saudi Arabia.
Healthcare (Basel). 2025 Aug 1;13(15):1887. doi: 10.3390/healthcare13151887.
: Benign paroxysmal positional vertigo (BPPV) is the most prevalent vestibular disorder encountered in clinical settings and is highly responsive to evidence-based diagnostic and therapeutic interventions. However, variations in practice patterns among physician specialties can compromise timely diagnosis and effective treatment. Understanding these variations is essential for improving clinical outcomes and standardizing care. This study aimed to assess the diagnostic and treatment practices for BPPV among Ear, Nose, and Throat (ENT) specialists, neurologists, general practitioners, and family physicians in Saudi Arabia and to examine how these practices are influenced by clinical experience and patient case exposure. : A cross-sectional, questionnaire-based study was conducted between April 2023 and March 2024 at King Khalid University, Abha, Saudi Arabia. A total of 413 physicians were recruited using purposive sampling. Data were analyzed using IBM SPSS version 24.0. Parametric tests, including one-way ANOVA and chi-square tests, were used to assess differences across groups. A -value of <0.05 was considered statistically significant. : Overall, all physician groups exhibited limited adherence to guideline-recommended positional diagnostic and therapeutic maneuvers. However, ENT specialists and neurologists demonstrated relatively higher compliance, particularly in performing the Dix-Hallpike test, with 46.97% and 26.79% reporting "always" using the maneuver, respectively ( < 0.001, Cramér's V = 0.22). Neurologists were the most consistent in conducting oculomotor examinations, with 73.68% reporting routine performance ( < 0.001, Cramér's V = 0.35). Epley maneuver usage was highest among neurologists (86.36%) and ENT specialists (77.14%) compared to family physicians (50.60%) and GPs (67.50%) ( = 0.044). Physicians with 11-15 years of experience and >50 BPPV case exposures consistently showed a greater use of diagnostic maneuvers, repositioning techniques, and guideline-concordant medication use (betahistine 76.67%; < 0.001). Continuing medical education (CME) participation and the avoidance of unnecessary imaging were also highest in this group (46.67% and 3.33%, respectively; < 0.001). : Significant inter-specialty differences exist in the management of BPPV in Saudi Arabia. Greater clinical experience and higher case exposure are associated with improved adherence to evidence-based practices. Targeted educational interventions are needed, particularly in primary care, to enhance guideline implementation.
良性阵发性位置性眩晕（BPPV）是临床中最常见的前庭疾病，对循证诊断和治疗干预反应良好。然而，不同专科医生的诊疗模式存在差异，这可能会影响及时诊断和有效治疗。了解这些差异对于改善临床结局和规范医疗护理至关重要。本研究旨在评估沙特阿拉伯耳鼻喉科（ENT）专科医生、神经科医生、全科医生和家庭医生对BPPV的诊断和治疗实践，并探讨这些实践如何受到临床经验和患者病例接触情况的影响。
2023年4月至2024年3月期间，在沙特阿拉伯阿卜哈的哈利德国王大学进行了一项基于问卷调查的横断面研究。采用目的抽样法共招募了413名医生。使用IBM SPSS 24.0版软件对数据进行分析。使用包括单因素方差分析和卡方检验在内的参数检验来评估各组之间的差异。P值<0.05被认为具有统计学意义。
总体而言，所有医生群体对指南推荐的位置性诊断和治疗手法的依从性都有限。然而，耳鼻喉科专科医生和神经科医生的依从性相对较高，尤其是在进行Dix-Hallpike试验时，分别有46.97%和26.79%的医生报告“总是”使用该手法（P<0.001，克莱默V值=0.22）。神经科医生在进行动眼神经检查方面最为一致，有73.68%的医生报告常规进行该检查（P<0.001，克莱默V值=0.35）。与家庭医生（50.60%）和全科医生（67.50%）相比，神经科医生（86.36%）和耳鼻喉科专科医生（77.14%）使用Epley手法的比例最高（P=0.044）。有11至15年经验且接触过50例以上BPPV病例的医生始终更多地使用诊断手法、复位技术和符合指南的药物治疗（倍他司汀使用率为76.67%；P<0.001）。该组医生参加继续医学教育（CME）的比例和避免不必要影像学检查的比例也最高（分别为46.67%和3.33%；P<0.001）。
在沙特阿拉伯，BPPV的管理存在显著的专科间差异。更多的临床经验和更高的病例接触量与更好地遵循循证实践相关。需要有针对性的教育干预措施，特别是在初级保健领域，以加强指南实施。
