Association of Serum Calcium and Vitamin D with Benign Paroxysmal Positional Vertigo

Abstract Introduction Benign paroxysmal positional vertigo (BPPV) is one of the common disorders of the peripheral vestibular system. The prevalence of BPPV is found to be higher among middle-aged women. Objectives To estimate the serum levels of calcium and vitamin D in patients with BPPV, and to study their association. Methods The present is a hospital-based prospective case-control study. Venous blood samples of the 49 patients with BPPV and an equal number of age- and gender-matched individuals were recruited and submitted to an analysis of the serum levels of calcium and vitamin D. Results Among the cases, 67.3% were found to be females, and 32.7% were males. Most of the 30 cases (61.3%) were aged >40 years. The mean age of the cases was 44.39 years. The mean serum level of vitamin D in the cases was of 21.26 ng/ml compared with 17.59 ng/ml in the controls. The mean serum level of calcium was of 9.33 mg/dl in the cases, compared with 8.95 mg/dl in the controls. There was no significant difference in the serum levels of vitamin D and calcium between cases and controls. Conclusion We could not establish any correlation between the serum levels of calcium and vitamin D with BPPV. However, a negative relationship was found between the serum levels of vitamin D and the number of episodes of BPPV (p = 0.012).

Results of Bone Mineral Density Measurement in Woman Patients with Idiopathic Benign Paroxysmal Positional Vertigo / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It has been proposed that displaced particles arising from otoconial degeneration are the leading cause of idiopathic BPPV (iBPPV). Otoconial degeneration might be linked with skeletal decalcification due to both conditions being related to a disturbance in calcium metabolism. The aim of this study was to evaluate the results of bone mineral density (BMD) measurement in women with iBPPV. SUBJECTS AND METHOD: Fifty-four women with iBPPV underwent BMD test and the results were given as a T-score. We compared the T-scores of the patients with those of 173 healthy women by age and by the presence of menopause, and we also compared the T-scores by type of iBPPV among the premenopausal patients. RESULTS: In all age groups, the mean T-score was significantly lower in the patients group than in the control group (p<.001). Regardless of the presence of menopause, the mean T-score in the patients was significantly lower than that in the control group (p<.001). By type of iBPPV, there was no significant difference in the T-scores among the groups. CONCLUSION: This study demonstrates that the values of BMD measurement in women with iBPPV were significantly lower than in the control group regardless of age or the presence of menopause. The results of this study suggest that iBPPV is linked with calcium metabolism. Future study will elucidate the utility of the therapy for disturbed calcium metabolism to decrease the recurrence of iBPPV.

Aging Effect on the Morphology of the Otoconia Using Scanning Electron Microscopy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Displaced otoconia in the semicircular canal from senile otoconial degeneration have been believed as a major cause of benign paroxysmal positional vertigo (BPPV). The otoconia are mainly composed of calcium carbonate, and thus they are susceptible to chemical deformation during the usual process of scanning electron microscopy (SEM). The aims of this study were to present an optimal protocol of otoconial preparation for SEM and to investigate the change of otoconial morphology due to aging. SUBJECTS AND METHOD: The macula in mice were dissected free from the temporal bone and were divided into three groups using different fixatives and buffers: 2.5% glutaraldehyde in phosphate buffer, 2.5% glutaraldehyde in cacodylate buffer and 70% acetone. The duration of storage in buffer differed for each group, and SEM was used to examine the morphology. After the optimal processing protocol was made, we analysed the difference in the otoconial morphology in younger and older rats. RESULTS: The otoconia with shorter storage duration in phosphate buffer had more clear surface, while longer exposures resulted in coarse surface and fused otoconia. The otoconia stored in cacodylate buffer had smooth surface and showed grossly normal morphology regardless of exposure time. The otoconia fixed in acetone had irregular surface and was easily displaced. In older rats, the bodies of many otoconia were pitted, fissured, penetrated and eventually broken into several fragments. The size variation of utricular otoconia was greater in older rats. The giant otoconia were discovered frequently on the outer margin of utricular macula in older rats. The weakened or linked filaments that were cut in the older group were frequently observed. CONCLUSION: The appropriate processing for SEM is needed to observe the intact otoconial morphology. Older rats showed more degeneration of otoconia and linked filaments. This study for morphologic changes of senile otoconia is expected to be helpful in understanding the etiology of BPPV and aging effect.