Benign paroxystic positional vértigo and Menière’s disease: a retrospective análisis
Abstract Introduction and objective: Benign Paroxysmal Positional Vertigo (BPPV) is more frequent within the subgroup of patients with Menière's Disease (MD). The present study aims to describe the clinical characteristics of both BPPV and MD, when they are associated. Method: We carried out a retrospective analysis of 22 patients with MD diagnosed with BPPV between 1999 and 2021 at the University Assistance Complex of Salamanca. Clinical variables were collected, both from the characteristics of BPPV and MD. Results: In our database, 66.66% of the 22 patients were women with a mean age of 59.33 years. The most frequently affected semicircular canal was the posterior right. Regarding BPPV, 19% are multichannel BPPV, in almost half (47.62%) more than three maneuvers had to be performed to solve it and it took more than a month to resolve it in more than half (57.14%). On the other hand, MD was bilateral in 19% of patients, with a time since diagnosis of more than three years in 71.42%. A third of the patients had presented more than 10 crises in the last six months, and fluctuation in hearing. Based on these results, it appears that patients with advanced MD are more likely to have BPPV and have a worse treatment outcome. Conclusion: The joint appearance of BPPV and MD could affect the prognosis of both pathologies separately.
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Vázquez Muñoz MI, Gómez Tapiador MP, Oliva Domínguez M. Síndromes vestibulares periféricos: enfermedad de Ménière, neuronitis vestibular, vértigo posicional paroxístico benigno, cirugía del vértigo. Libro virtual de formación en ORL. Disponible en: https://seorl.net/PDF/Otologia/035%20-%20S%C3%8DNDROMES%20VESTIBULARES%20PERIF%C3%89RICOS%20ENFERMEDAD%20DE%20MENIERE,%20NEURONITIS%20VESTIBULAR,%20V%C3%89RTIGO%20POSICIONAL%20PAROX%C3%8DSTICO%20BENIGNO.pdf
Basura GJ, Adams ME, Monfared A, Schwartz SR, Antonelli PJ, Burkard R. Clinical Practice Guideline: Ménière’s Disease.Otolaryngol. Head Neck Surg. 2020;162:1-55.
Mizukoshi K, Shojaku H, Aso S, Asai M, Wanatabe Y. Ménière´s disease and delayed endolymphatic hydrops in children. Acta Otolaryngol. 2001;545:6-9.
Ballester M, Liard P, Vibert D, Hausler R. Ménière´s disease in the elderly. Otol Neurotol. 2002;23:73-8.
Perez Garriguez H, López Escámez JA, Morales Angulo C, Pérez Fernández N. Enfermedad de Ménière: desde las ciencias básicas hacia la medicina clínica. 1ª ed. Badalona: Schering-Plough; 2009.
Kutlubaev MA, Xu Y, Hornibrook J. Benign paroxysmal positional vertigo in Meniere’s disease: systematic review and meta-analysis of frequency and clinical characteristics. J Neurol. 2021;268:1608-14.
Lopez-Escamez JA, Carey J, Chung WH, Goebel JA, Magnusson M, Mandalà M, et al. Criterios diagnósticos de enfermedad de Menière. Documento de consenso de la Bárány Society, la Japan Society for Equilibrium Research, la European Academy of Otology and Neurotology (EAONO), la American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) y la Korean Balance Society. Acta otorrinolaringologica espanola, 67(1), 1–7. https://doi.org/10.1016/j.otorri.2015.05.005.
Ganança MM, Caovilla HH, Munhoz MSL, Ganança CF, Silva MLG, Serafini F et al. Optimizando o componente farmacológico da terapia integrada da vertigem. Rev. Bras. Otorrinolaringol. 2007;73:12-8.
Carnevale C, Muñoz Proto F, Rama López J, Ferrán De la Cierva L, Rodríguez Villalba R, Sarría Echegaray P, et al. Manejo del vértigo posicional paroxístico benigno en atención primaria. Semergen. 2014; 40: 254-260.
Neira P, Valenzuela V, Viada J. Semiología del vértigo postural paroxístico benigno. Rev Otorrinolaringol Cir Cabeza Cuello. 2001;61:5-12.
Yetişer S. Co-existence of benign paroxysmal positional vertigo and Meniere’s syndrome. J Int Adv Otol. 2017;13:65-8.
Balatsouras DG, Ganelis P, Aspris A, Economou NC, Moukos A, Koukoutsis G. Benign paroxysmal positional vertigo associated with Meniere’s disease: epidemiological, pathophysiologic, clinical, and therapeutic aspects. Ann Otol Rhinol Laryngol. 2012;121:682-8.
Gross EM, Ress BD, Viirre ES, Nelson JR, Harris JP. Intractable benign paroxysmal positional vertigo in patients with Meniere’s disease. Laryngoscope. 2000;110:655-9.
Li P, Zeng X, Li Y, Zhang G, Huang X. Clinical analysis of benign paroxysmal positional vertigo secondary to Meniere's disease. Sei Res Essays 2010;5:3672-5.
Chen J, Zhang S, Cui K, Liu C. Risk factors for benign paroxysmal positional vertigo recurrence: a systematic review and meta-analysis. J Neurol. 2021;268(11):4117
Mastroleo I. Consideraciones sobre las obligaciones posinvestigación en la Declaración de Helsinki 2013. Rev. Bioética y Derecho [Internet]. 2014 [citado el 26 de noviembre de 2022];(31):51–65. Disponible en: https://revistes.ub.edu/index.php/RBD/article/view/10438
Katsarkas A, Kirkham TH. Paroxysmal positional vertigo - a study of 255 cases. J Otolaryngol 1978;7: 320-30.
Hughes CA, Proctor L. Benign paroxysmal positional vertigo. Laryngoscope 1997;107:607-13.
Pal’chun, VT, Mel’nikov OA, Levina YV, Guseva AL. The peculiar features of the clinical course of Meniere’s disease associated with benign paroxysmal positional vertigo. Vestn Otorinolaringol. 2018;83(1):32-5.
Von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T, et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry. 2007;78:710-5.
Riga M, Bibas A, Xenellis J, Korres S. Inner ear disease and benign paroxysmal positional vertigo: a critical review of incidence, clinical characteristics, and management. Int J Otolaryngol. 2011; Vol 2011: ID 709469.Disponible en: https://pubmed.ncbi.nlm.nih.gov/21837242/
Karlberg M, Hall K, Quickert N, Hinson J, Halmagyi GM. What inner ear diseases cause benign paroxysmal posi- tional vertigo? Acta Otolaryngol 2000;120:380-5.
Morita N, Cureoglu S, Nomiya S, Nomiya R, Joglekar SS, Harada T, et al. Potential cause of positional vertigo in Meniere’s disease. Otol Neurotol 2009;30(7):956–60.
Perez N, Martin E, Zubieta JL, Romero MD, Garcia-Tapia R. Benign paroxysmal positional vertigo in patients with Ménière’s disease treated with intratympanic gentamycin. Laryngoscope. 2002;112:1104-9.
Pérez Vázquez P, Franco Gutiérrez V, Soto Varela A, Amor-Dorado JC, Martín-Sanz E, Oliva Domínguez M, et al. Guía de práctica clínica para el diagnóstico y tratamiento del vértigo posicional paroxístico benigno [citado el 26 de noviembre de 2022]. Disponible en: https://seorl.net/wp-content/uploads/2016/05/Gu%C3%ADa-VPPB.pdf
Hornibrook J, Bird P. A new theory for Meniere’s disease: detached saccular otoconia. Otolaryngol. Head Neck Surg. 2017; 156:350–2.
Luryi, AL, Lawrence J, Bojrab D, LaRouere M, Babu S, Hong R, et al. Patient, disease and outcome characteristics of benign paroxysmal positional vertigo with and without Meniere’s disease. Acta Otolaryngol. 2018;138(10):893-7.
Psillas, G, Triaridis S, Markou K, Tsalighopoulos M, Vital V. Benign paroxysmal positional vertigo in the first acute attack of Ménière’s Disease. B-ENT: 2011;7(2):131-5.
Handa PR, Kuhn AMB, Schaffleln R, Ganança FF. Qualidade de vida em pacientes com vertigem posicional paroxística benigna e/ou doença de Ménière.Rev. Bras. Otorrinolaringol. 2005, 71:776-83.
Socher DD, Socher JA, Azzi VJB. Evaluation of quality of life pre- and post- vestibular rehabilitation in patients with benign paroxysmal positional vertigo associated with Meniere’s disease. Int Arch Otorhinolaryngol. 2012;16(4):430-6.
Paparella MM. Benign paroxysmal positional vertigo and other vestibular symptoms in Meniere disease. Ear Nose Throat J 2008;87:562.
Basura GJ, Adams ME, Monfared A, Schwartz SR, Antonelli PJ, Burkard R. Clinical Practice Guideline: Ménière’s Disease.Otolaryngol. Head Neck Surg. 2020;162:1-55.
Mizukoshi K, Shojaku H, Aso S, Asai M, Wanatabe Y. Ménière´s disease and delayed endolymphatic hydrops in children. Acta Otolaryngol. 2001;545:6-9.
Ballester M, Liard P, Vibert D, Hausler R. Ménière´s disease in the elderly. Otol Neurotol. 2002;23:73-8.
Perez Garriguez H, López Escámez JA, Morales Angulo C, Pérez Fernández N. Enfermedad de Ménière: desde las ciencias básicas hacia la medicina clínica. 1ª ed. Badalona: Schering-Plough; 2009.
Kutlubaev MA, Xu Y, Hornibrook J. Benign paroxysmal positional vertigo in Meniere’s disease: systematic review and meta-analysis of frequency and clinical characteristics. J Neurol. 2021;268:1608-14.
Lopez-Escamez JA, Carey J, Chung WH, Goebel JA, Magnusson M, Mandalà M, et al. Criterios diagnósticos de enfermedad de Menière. Documento de consenso de la Bárány Society, la Japan Society for Equilibrium Research, la European Academy of Otology and Neurotology (EAONO), la American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) y la Korean Balance Society. Acta otorrinolaringologica espanola, 67(1), 1–7. https://doi.org/10.1016/j.otorri.2015.05.005.
Ganança MM, Caovilla HH, Munhoz MSL, Ganança CF, Silva MLG, Serafini F et al. Optimizando o componente farmacológico da terapia integrada da vertigem. Rev. Bras. Otorrinolaringol. 2007;73:12-8.
Carnevale C, Muñoz Proto F, Rama López J, Ferrán De la Cierva L, Rodríguez Villalba R, Sarría Echegaray P, et al. Manejo del vértigo posicional paroxístico benigno en atención primaria. Semergen. 2014; 40: 254-260.
Neira P, Valenzuela V, Viada J. Semiología del vértigo postural paroxístico benigno. Rev Otorrinolaringol Cir Cabeza Cuello. 2001;61:5-12.
Yetişer S. Co-existence of benign paroxysmal positional vertigo and Meniere’s syndrome. J Int Adv Otol. 2017;13:65-8.
Balatsouras DG, Ganelis P, Aspris A, Economou NC, Moukos A, Koukoutsis G. Benign paroxysmal positional vertigo associated with Meniere’s disease: epidemiological, pathophysiologic, clinical, and therapeutic aspects. Ann Otol Rhinol Laryngol. 2012;121:682-8.
Gross EM, Ress BD, Viirre ES, Nelson JR, Harris JP. Intractable benign paroxysmal positional vertigo in patients with Meniere’s disease. Laryngoscope. 2000;110:655-9.
Li P, Zeng X, Li Y, Zhang G, Huang X. Clinical analysis of benign paroxysmal positional vertigo secondary to Meniere's disease. Sei Res Essays 2010;5:3672-5.
Chen J, Zhang S, Cui K, Liu C. Risk factors for benign paroxysmal positional vertigo recurrence: a systematic review and meta-analysis. J Neurol. 2021;268(11):4117
Mastroleo I. Consideraciones sobre las obligaciones posinvestigación en la Declaración de Helsinki 2013. Rev. Bioética y Derecho [Internet]. 2014 [citado el 26 de noviembre de 2022];(31):51–65. Disponible en: https://revistes.ub.edu/index.php/RBD/article/view/10438
Katsarkas A, Kirkham TH. Paroxysmal positional vertigo - a study of 255 cases. J Otolaryngol 1978;7: 320-30.
Hughes CA, Proctor L. Benign paroxysmal positional vertigo. Laryngoscope 1997;107:607-13.
Pal’chun, VT, Mel’nikov OA, Levina YV, Guseva AL. The peculiar features of the clinical course of Meniere’s disease associated with benign paroxysmal positional vertigo. Vestn Otorinolaringol. 2018;83(1):32-5.
Von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T, et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry. 2007;78:710-5.
Riga M, Bibas A, Xenellis J, Korres S. Inner ear disease and benign paroxysmal positional vertigo: a critical review of incidence, clinical characteristics, and management. Int J Otolaryngol. 2011; Vol 2011: ID 709469.Disponible en: https://pubmed.ncbi.nlm.nih.gov/21837242/
Karlberg M, Hall K, Quickert N, Hinson J, Halmagyi GM. What inner ear diseases cause benign paroxysmal posi- tional vertigo? Acta Otolaryngol 2000;120:380-5.
Morita N, Cureoglu S, Nomiya S, Nomiya R, Joglekar SS, Harada T, et al. Potential cause of positional vertigo in Meniere’s disease. Otol Neurotol 2009;30(7):956–60.
Perez N, Martin E, Zubieta JL, Romero MD, Garcia-Tapia R. Benign paroxysmal positional vertigo in patients with Ménière’s disease treated with intratympanic gentamycin. Laryngoscope. 2002;112:1104-9.
Pérez Vázquez P, Franco Gutiérrez V, Soto Varela A, Amor-Dorado JC, Martín-Sanz E, Oliva Domínguez M, et al. Guía de práctica clínica para el diagnóstico y tratamiento del vértigo posicional paroxístico benigno [citado el 26 de noviembre de 2022]. Disponible en: https://seorl.net/wp-content/uploads/2016/05/Gu%C3%ADa-VPPB.pdf
Hornibrook J, Bird P. A new theory for Meniere’s disease: detached saccular otoconia. Otolaryngol. Head Neck Surg. 2017; 156:350–2.
Luryi, AL, Lawrence J, Bojrab D, LaRouere M, Babu S, Hong R, et al. Patient, disease and outcome characteristics of benign paroxysmal positional vertigo with and without Meniere’s disease. Acta Otolaryngol. 2018;138(10):893-7.
Psillas, G, Triaridis S, Markou K, Tsalighopoulos M, Vital V. Benign paroxysmal positional vertigo in the first acute attack of Ménière’s Disease. B-ENT: 2011;7(2):131-5.
Handa PR, Kuhn AMB, Schaffleln R, Ganança FF. Qualidade de vida em pacientes com vertigem posicional paroxística benigna e/ou doença de Ménière.Rev. Bras. Otorrinolaringol. 2005, 71:776-83.
Socher DD, Socher JA, Azzi VJB. Evaluation of quality of life pre- and post- vestibular rehabilitation in patients with benign paroxysmal positional vertigo associated with Meniere’s disease. Int Arch Otorhinolaryngol. 2012;16(4):430-6.
Paparella MM. Benign paroxysmal positional vertigo and other vestibular symptoms in Meniere disease. Ear Nose Throat J 2008;87:562.
Fernández-Bardón, I., Pacheco-López, S., Peña-Navarro, P., Marcos-Alonso, S., Calvo-Boizas, E., & Batuecas-Caletrio, Ángel. (2023). Benign paroxystic positional vértigo and Menière’s disease: a retrospective análisis . Revista ORL, 14(2), e30969. https://doi.org/10.14201/orl.30969
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