The Effects of the Vestibular Rehabilitation on the Benign Paroxysmal Positional Vertigo Recurrence Rate in Patients with Otolith Dysfunction

BACKGROUND AND OBJECTIVES: Although repositioning maneuvers have shown remarkable success rate in treatments of benign paroxysmal positional vertigo (BPPV), the high recurrence rate of BPPV has been an important issue. The aims of present study were to examine the effects of otolith dysfunction on BPPV recurrence rate and to describe the effect of vestibular rehabilitation exercises on BPPV recurrence in BPPV patients with concomitant otolith dysfunction. SUBJECTS AND METHODS: Forty-five BPPV patients included in this study (three groups). Patients in group 1 had no otolith dysfunction and patients in groups 2 and 3 had concomitant otolith dysfunction. Otolith dysfunction was determined with ocular/cervical vestibular evoked myogenic potential (oVEMP and cVEMP) abnormalities. Epley’s maneuver was performed for the patients in all groups but patients in group 3 also received a 2-month vestibular rehabilitation program (habituation and otolith exercises). RESULTS: This study showed that BPPV recurrent rate was significantly higher in patients with otolith dysfunction in comparison to the group 1 (p < 0.05). Vestibular rehabilitation resulted in BPPV recurrence rate reduction. Utricular dysfunction showed significant correlation with BPPV recurrence rate. CONCLUSIONS: Otolith dysfunction can increase BPPV recurrence rate. Utricular dysfunction in comparison to saccular dysfunction leads to more BPPV recurrence rate. Vestibular rehabilitation program including habituation and otolith exercises may reduce the chance of BPPV recurrence.

[Hearing aid effect on elderly's depression in Tehran's nursing homes]

Moderate hearing impairment in older age can affect physical and psychosocial health of people. The rate of isolation, lack of self confidence, depression and probably dementia in this people is high. This study was conducted to study the hearing aid effect on older adults depression in Tehran nursing homes. In this study depression was assessed in 3 groups of older adults: 30 normal hearing older adults, 30 hearing impaired older adults without hearing aid and 20 hearing impaired older adults with hearing aid. Beck Depression Inventory [II] was used to assess depression. For analyzing data one way ANOVA was used. Mean scores in BDI was 11, 43, 21, 53, 16, 40 for groups. The difference between groups was significant. Correlation between age and depression was significant in 1 and 3 groups. It seems that hearing aid use is effective in decreasing depression in older adults