Osteoporosis as a risk factor for the recurrence of benign paroxysmal positional vertigo

Authors

  • Toshiaki Yamanaka MD,

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, Nara Medical University School of Medicine, Nara, Japan; and the
    • Send correspondence to Toshiaki Yamanaka, MD, Department of Otolaryngology–Head and Neck Surgery, Nara Medical University School of Medicine, 840 Shijo, Kashihara Nara, 634-8522, Japan. E-mail: toshya@naramed-u.ac.jp

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  • Shiho Shirota MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Nara Medical University School of Medicine, Nara, Japan; and the
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  • Yachiyo Sawai MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Nara Medical University School of Medicine, Nara, Japan; and the
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  • Takayuki Murai MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Nara Medical University School of Medicine, Nara, Japan; and the
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  • Nobuya Fujita MD,

    1. Department of Otorhinolaryngology, Nara Prefectural Hospital, Nara, Japan
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  • Hiroshi Hosoi MD

    1. Department of Otolaryngology–Head and Neck Surgery, Nara Medical University School of Medicine, Nara, Japan; and the
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  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis

Benign paroxysmal positional vertigo (BPPV) frequently occurs in females over 50 years old, suggesting that a postmenopausal decrease in estrogen secretion might be involved in its onset. An estrogen deficiency is generally known to cause osteoporosis through a reduction in bone mass. This study was designed to investigate a clinical association between idiopathic BPPV and osteoporosis.

Study Design

Case-control study.

Methods

We measured the bone mineral density (BMD) at the lumbar vertebrae in 61 patients with idiopathic BPPV who were postmenopausal women over 50 years old using dual-energy x-ray absorptiometry. After being treated with the canalith repositioning maneuver, the patients were followed up for at least 1 year.

Results

Our results showed that the incidence of osteoporosis in patients with BPPV was 26.2%, which was similar to those observed in epidemiological surveys conducted in Japan. However, we found that in BPPV patients with osteoporosis, the incidence of recurrence was 56.3%, which was significantly higher than that observed in patients with normal bone mineral density (16.1%). Furthermore, the frequency of BPPV recurrence increased as BMD decreased.

Conclusions

These results suggest that osteoporosis is a risk factor for BPPV recurrence. The prognosis of BPPV might be clinically predicted by BMD reduction.

Level of Evidence

3b Laryngoscope, 123:2813–2816, 2013

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