[Analysis of 118 cases of benign paroxysmal positional vertigo after trauma].

Objective:The aim of this study is to retrospective analysis the clinic features of 118 cases of benign paroxysmal positional vertigo after trauma. Method:Analyzes clinic features of injury in 118 cases of benign paroxysmal positional vertigo after trauma, and classified and localized the craniocerebral trauma. The 118 cases were tested with different positioning tests in the sequence of Dix hallpike test and rolling test. Then, proper otolith manual reduction was given. Result:In 118 cases of BPPV after trauma including 35 cases of skull fracture, 6 cases of concussion, 17 cases of scalp hematoma, 28 cases of scalp laceration, 14 cases of mild brain contusion and 18 cases of head combined injury. The distributions of head injury were 57 at front temporal, 24 at top, 22 at occipital and 15 at maxillofacial region. The latency of BPPV after head injury varies from 1day to 1month. The incidence of 3-7 day after head injury was the highest, followed by 7-14 days, 0-3 days, and the lowest incidence rate of 14 day to 1 month. Canal type 118 BPPV patients after head injury accounting for up to 57.6% of the horizontal semicircular canal accounted for 33.1%, mixed 9.3%. Conclusion:The patients with front temporal trauma and skull fracture were prone to have BPPV. The peak incidence of BPPV was 3-14 days after head injury. The most common type of BPPV was PC BPPV, and the HC BPPV was the second type. A good curative effect can be manipulative reduction after trauma BPPV..

Sleep position and laterality of benign paroxysmal positional vertigo.

OBJECTIVE: The aim of this study was to investigate the frequency of posterior semicircular canal benign paroxysmal positional vertigo in each ear, and to assess the association between the ear affected by benign paroxysmal positional vertigo and the head-lying side during sleep onset. Based on a previous study which used objective methods to prove the preference of the elderly for the right head-lying side during sleep, we hypothesised that a predominance of the same head-lying side in benign paroxysmal positional vertigo patients may affect the pathophysiology of otoconia displacement. STUDY DESIGN: We conducted a prospective study of out-patients with posterior semicircular canal benign paroxysmal positional vertigo, confirmed by a positive Dix-Hallpike test. METHODS: One hundred and forty-two patients with posterior semicircular canal benign paroxysmal positional vertigo were interviewed about their past medical history, focusing on factors predisposing to benign paroxysmal positional vertigo. All patients included in the study were able to define a predominant, favourite head-lying side, right or left, during sleep onset. RESULTS: The Dix-Hallpike test was found to be positive on the right side in 82 patients and positive on the left side in 54; six patients were found to be positive bilaterally. During sleep onset, 97 patients habitually laid their head on the right side and the remaining 45 laid their head on the left. The association between the affected ear and the head-lying side during sleep onset was statistically significant (p < 0.001). CONCLUSIONS: Our study found a predominance of right-sided benign paroxysmal positional vertigo, a subjective preference amongst patients for a right head-lying position during sleep onset, and an association between the ear affected by benign paroxysmal positional vertigo and the preferred head-lying side during sleep onset. The clinical and therapeutical implications of this observation are discussed.

[Histopathology of nonacoustic labyrinth following head injury in guinea pigs].

The histopathological changes in nonacoustic labyrinth induced by experimental head injury were studied in 11 guinea pigs. The animals were divided into two groups. The first group were killed after the pain sense recovered and the second group were allowed to survive for 15 days. The temporal bones were serially sectioned and observed under light microscope. The pathological findings of the vestibular organs included arrangement disturbance, lytic, exfoliate and vacuolization of the sensory epithelia, massive spherical bodies in the region of cilium. The otolithic membranes were exfoliated in the utricular and saccular maculae. There was the otolith by the ductus reuniens separated from the saccular maculae in one ear. There were basophilic staining homogenous deposit on the cristae ampullaris. These findings showed that impairments of vestibulae following head injury were obvious. The secondary impairments, cupulolithiasis and obstruction of the ductus reuniens, from the utricular and saccular maculae were one of the pathologic changes in hearing loss and vertigo following head injury.