耳鼻咽喉科診療所における良性発作性頭位めまい症の再発例の検討

抄録

　 We conducted this study in a total of 442 patients who had visited the first author's clinic between February 1, 2011, and June 30, 2018, were diagnosed as having and been treated for benign paroxysmal positional vertigo (BPPV), and had remained free of relapse for more than one month, in order to examine the recurrence rate/pattern of BPPV. Until May 1, 2020, 266 cases were directly examined for recurrence/non-recurrence of BPPV upon their revisit to the clinic (exam group). The remaining 176 patients did not revisit our clinic after the initial treatment and answered our questionnaire concerning the recurrence of BPPV by mail (questionnaire group). Of all the 442 cases of BPPV, the BPPV originated from the lateral canal (LC-BPPV) in 41.6% of cases and from the posterior canal (PC-BPPV) in 57.9% of cases (P<0.001). Recurrence of BPPV was observed in 209 out of the 266 cases in the exam group, and 54 out of the 176 cases in the questionnaire group. The non-recurrence rate was 73.0% at 12 months, 50.0% at 31.4 months, and 26.3% at 60 months. The average interval to recurrence, overall, was 35.4 months. In patients with PC-BPPV, the rate of relapse on the left side was significantly higher than the rate of relapse on the right side (58.2% vs. 41.2%) (P<0.001). The relapse rate of PC-BPPV was significantly higher than that of LC-BPPV (65.2% vs. 51.1%) (P=0.0016). The relapse rate in cases of PC-BPPV in whom the relapse occurred in the PC was significantly higher than that in cases of LC-BPPV in whom the relapse occurred in the LC (56.5% vs. 39.8%) (P=0.0041). There was no significant difference in the relapse rates between the female and male participants.