Treatment and recurrence of traumatic versus idiopathic benign paroxysmal positional vertigo: a meta-analysis

Abstract

Background: So far, there has been a controversy surrounding repositioning difficulty and recurrence rate between traumatic benign paroxysmal positional vertigo (t-BPPV) and idiopathic BPPV (i-BPPV).

Objectives: This meta-analysis was aimed to explore whether or not the differences between t-BPPV and i-BPPV in the repositioning difficulty and recurrence rate existed.

Material and methods: A literature search was performed in the databases including Pubmed, Embase, CENTRAL, which completed in 21 January 2019, with no restriction of publication language. Relative risk (RR) of number of repositioning maneuvers and the recurrence rate was calculated with its 95% confidence interval. Sensitive analysis was performed simultaneously.

Results: Six retrospective cohort studies were included in our meta-analysis, including 865 t-BPPV patients and 3027 i-BPPV patients. All studies were high quality according to Newcastle-Ottawa Scale (NOS) assessment. Patients with t-BPPV required more repositioning maneuvers for resolution than those with i-BPPV (RR = 3.27, 95% CI = 1.88–5.69, p < .0001), and the recurrence rate of t-BPPV was higher than that of i-BPPV (RR = 2.91, 95% CI = 2.04–4.14, p < .00001).

Conclusions and significance: Compared with i-BPPV, patients with t-BPPV require more repositioning maneuvers to resolve, and the recurrence of t-BPPV was more frequent.

背景：到目前为止, 关于创伤性良性阵发性位置性眩晕（t-BPPV）和特发性BPPV（i-BPPV）之间的重新定位难度和复发率存在着争议。

目的：本荟萃分析旨在探讨t-BPPV和i-BPPV在重新定位难度和复发率方面是否存在差异。

材料和方法：在包括Pubmed、Embase、CENTRAL在内的数据库中进行了文献检索, 并于1月21日完成, 没有受出版语言的限制。通过其95％置信区间计算重新定位操作次数和复发率的相对风险（RR）。与此同时 进行敏感分析。

结果：我们的荟萃分析包括6项回顾性队列研究, 包括865名t-BPPV患者和3027名i-BPPV患者。根据纽卡斯尔 - 渥太华量表（NOS）评估, 所有研究都是高质量的。t-BPPV患者比i-BPPV患者需要更多的重新定位操作（RR = 3.27,95％CI = 1.88-5.69, p <.001）, t-BPPV的复发率高于i-BPPV（RR = 2.91,95％CI = 2.04-4.14, p <.00001）。

结论和意义：与i-BPPV相比, t-BPPV患者需要更多的重新定位操作来解决, 并且t-BPPV的复发更为频繁。

Keywords:

• Benign paroxysmal positional vertigo
• traumatic
• idiopathic
• repositioning
• recurrence

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This work was supported by the Key Technologies R & D Program of Shandong Province of China under Grant no. 2011GSF11844.