继发于耳源性疾病的良性阵发性位置性眩晕的临床分析

Clinical Analysis of Benign Paroxysmal Positional Vertigo Secondary to Otogenic Diseases

目的:探讨继发于耳源性疾病的良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的临床特征。方法:回顾分析盐城市第三人民医院耳鼻咽喉科2010年1月—2012年6月收治的67例继发于耳源性疾病的BPPV(耳源性BPPV)患者的临床资料,并与同期119例原发性BPPV患者对照比较,分析耳源性BPPV的临床特点、病因及预后。所有患者均采用管石复位法治疗。结果:耳源性BPPV患者中包括突发性耳聋22例(32.8%),迷路炎17例(25.4%),梅尼埃病13例(19.4%),中-内耳手术后8例(11.9%),前庭神经元炎7例(10.4%)。耳源性BPPV与原发性BPPV两组患者年龄、性别、半规管受累情况的差异均无统计学差异(P>0.05)。突发性耳聋并发BPPV患者的年龄显著高于原发性BPPV患者(P<0.001),梅尼埃病并发BPPV患者行手法复位治疗的次数显著多于原发性BPPV患者(P=0.003)。结论:耳源性BPPV可继发于多种病因,不同耳源性病因所致BPPV的预后有所差别。

Objective： To analyze the clinical characteristics of benign paroxysmal positional vertigo （BPPV） secondary to otogenic diseases. Methods：The clinical data of 67 patients with otogenic BPPV admitted to department of otolaryngology in Third People＇s Hospital of Yancheng City from January 2010 to June 2012 was retrospectively analyzed. The outcome of patients with otogenie BPPV was compared with the idiopathic BPPV. All of the patients were treated with the canalith repositioning procedure （CRP）. Results： Among the 67 patients, 22 cases were secondary to sudden deafness, 17 cases were secondary to labyrinthitis, 13 cases were secondary to Meniere＇s disease, 8 cases were secondary to operations on the middle or inner ear, and 7 cases were secondary to vestibular neuronitis. There were no statistical difference in age, gender, lesion location in semicircular canal between orogenic BPPV patients and idiopathic BPPV patients （P〉0.05）. The patients seconda- ry to sudden deafness were significantly older than idiopathic BPPV patients （P〈0. 001）, while CRP times of BPPV patients secondary to Meniere＇s disease was significantly more than that of idiopathic BPPV patients （P = 0. 003）. Conclusions： The causes of otogenic BPPV is diverse, and prognosis of the otogenic BPPV is associated with the causes.