Serum Vitamin D and Long-term Outcomes of Benign Paroxysmal Positional Vertigo

OBJECTIVES: The purpose of the present study was to examine the effect of serum vitamin D concentrations on the long-term recurrence rates of benign paroxysmal positional vertigo (BPPV) patients. METHODS: The present study was conducted with patients diagnosed with BPPV from June 2014 to April 2016. Whether the patients' sex, age, types and locations of semicircular canals, diabetes, hypertension, hyperlipidemia, and vitamin D concentrations affect their recurrence rates was examined using Pearson chi-square tests, independent samples t-tests and Cox proportional hazards regression analyses. The effects of vitamin D concentrations on long-term recurrence rates were examined using Kaplan-Meier estimates and log-rank tests. RESULTS: The recurrence rates obtained with Kaplan-Meier estimates were 18% and 50% at 12 months and 24 months, respectively. When the patients were divided into groups with vitamin D concentrations of <10 ng/mL and ≥10 ng/mL and the recurrence rates of the groups were compared, the difference was statistically significant (P=0.040). In addition, when the patients were divided into groups with vitamin D concentrations of <15 ng/mL and ≥15 ng/mL and the recurrence rates of the groups were compared, the difference was statistically quite significant (P=0.017). In a Cox regression model, variables such as age, sex, the types and locations of semicircular canals, hypertension, diabetes, hyperlipidemia, and 25-hydroxy vitamin D did not significantly affect recurrence. CONCLUSION: The present study investigated the recurrence rates of BPPV in patients for a long time without limiting the sex, age, or locations of semicircular canals and it could be seen that serum vitamin D concentrations significantly affected the recurrence of BPPV.

Long-Term Outcomes of Canalith Repositioning for Benign Paroxysmal Positional Vertigo: Kaplan-Meier Estimate / 대한평형의학회지

OBJECTIVE: The objective of this study is to determine the long-term recurrence rate of benign paroxysmal positional vertigo (BPPV) and the factors associated to such recurrence. METHODS: Retrospective review was performed for 295 patients diagnosed as idiopathic BPPV. After successful resolution by particle repositioning maneuver, all patients were followed up by visiting clinic or telephone. A study period was 1–56 months and average follow up period for study population after the initial treatment was 26 months. The rate of recurrence was estimated according to the method of Kaplan-Meier and compared by the log-rank test. RESULTS: Overall recurrence rate by Kaplan-Meier estimate was 50% at 30 months. Kaplan-Meier estimate suggests the effect of patient age, sex and visit of treatment sessions in initial episode on BPPV recurrence over 3 year follow-up period. Recurrent rate was significantly higher in patients aged 40 years or older (p<0.013) and in patients with three or more visit of treatment sessions (p<0.015). However, there was no significant association between recurrence rate and sex. CONCLUSION: The long-term recurrence of BPPV was associated with age above 40 years and the number of visit for treatment sessions. This finding suggests that the recurrence of BPPV may be related with aging process.

Variables for One Year Recurrence of Benign Paroxysmal Positional Vertigo / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Although benign paroxysmal positional vertigo (BPPV) was treated with particle repositioning maneuver (PRM) with a high success rate, the condition often recurred. The purpose of this study was to evaluate the variables for one year recurrence of BPPV recurrence. SUBJECTS AND METHOD: Retrospective review was performed for 295 patients diagnosed as BPPV visiting clinic between February 2010 and June 2012. All patients underwent a complete otolaryngologic, audiologic, and neurologic evaluation. The appropriate PRM was performed, depending on the type of BPPV. Patients who received treatment were classified into two groups according to recurrence: a no recurrence group (n=240) and a recurrence group (n=55). Optimal independent variables were determined by using logistic regression analysis with forward stepwise selection. Binary logistic regression analyses were adjusted for age, sex, day of symptoms, associated ear disease, involved ear, type of otolith, affected canal and visit of treatment sessions. RESULTS: Average follow up time was 12 months. The recurrence rate was 18.6%. Two variables had a statistically significant impact on one year recurrence. The number of visits for treatment sessions was higher in the recurrence group than in the no recurrence group (mean+/-standard deviation=3.67+/-2.49 versus 2.44+/-1.55, p<0.001). The other variable was age being above 40 years (p=0.037). Age above 40 years was an independent variable for the one-year recurrence. Patient sex, day of symptoms, associated ear disease, involved ear, type of otolith and affected canal had no statistically significant impact. CONCLUSION: Our data suggested that the number of visit for treatment sessions and age above 40 years were variables associated with the one-year recurrence of BPPV.

Melnick-Fraser Syndrome in the Same Family / 대한이비인후과학회지

Melnick-Fraser syndrome is a rare congenital anomaly that is characterized by preauricular fistula, branchial fistula, hearing impairment, and is often combined with renal anomaly. Preauricular fistula and branchial fistula can occur in the same individual, but their association with hearing impairment is very rare. The condition is inherited in an autosomal dominant mode. Recently, we experienced a case of Melnick-Fraser syndrome in a 32 years old male patient with familial tendency. We report this case with a review of literature.

Management of Acute Laryngeal Trauma Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Laryngeal trauma is an uncommon but potentially catastrophic injury. The purpose of this study was to analyze the association between injury mechanism and the degree of injury, and to assess the outcome after the treatment. MATERIALS AND METHOD: A 10-year retrospective study of 21 patients with acute laryngeal trauma seen from 1988 to 1997 at Wonju Christian Hospital is presented. All patients are classified by injury mechanism (penetrating vs blunt) and degree of injury (Group I through V). These patients have been studied with attention to clinical manifestation, injury mechanism, degree of injury and outcome after the treatment. RESULTS: The main presenting symptoms and signs were dyspnea, hoarseness, tenderness and subcutaneous emphysema. Eleven cases were categorized as penetrating injury and the other ten cases as blunt injury. Sites of laryngeal injury included thyroid cartilage fracture, soft tissue laceration, cricoid cartilage fracture, pyriform sinus perforation and vocal folds injury. All patients were decannulated. Sixteen patients made a full return to normal voice, four were assessed fair but one was graded as poor. CONCLUSION: Conservative treatment of group II injuries was effective. In this cases, the greater the actual trauma, the poorer the results. Also, blunt trauma proved more serious than penetrating trauma and early surgical intervention was associated with better outcome. Authors suggest esophagoscopy to be performed at the time of operation.