Research On Correlation Between Benign Paroxysmal Positional Vertigo And Residual Dizziness After Canalith Repositioning Procedures With Serum Vitamin D Level

Background:Benign paroxysmal positional vertigo(BPPV)is the most common disease of vestibular vertigo,the main clinical manifestations are positional vertigo and nystagmus.The symptoms of vertigo seriously affect daily activities and work,and increase the risk of falls and fractures.And some patients have residual dizziness after successful Canalith repositioning procedures(CRP).Vitamin D deficiency is considered a risk factor for BPPV.The current research on BPPV and vitamin D levels has become the focus and hot spot.However,there are few studies with RD after reset.Objective:The relationship between the clinical parameters of BPPV and RD after reset and vitamin D levels will be observed.Determine the influencing factors of RD and evaluate its value in predicting RD.Methods :Selecting the first diagnosed BPPV patients from June 2020 to February 2021 in the vertigo outpatient clinic of Shaanxi Provincial people’s Hospital and SRM-Ⅳ the vestibular function diagnosis and treatment system.Clinical data such as gender,age and physical mass index(BMI),BPPV affected side and type,BPPV symptom duration,BPPV severity score,and laboratory data on serum 25-OH VitD were recorded.After Canalith repositioning procedures,BPPV patients were followed up by face-to-face and telephone interview for one month,During this period,the severity of RD and the duration of the residual dizziness were recorded.The patients were divided into two groups:residual dizziness group and no residual dizziness group according to the residual dizziness symptoms after Canalith repositioning procedures.According to the score,DHI was divided into three levels,including mild(0-30),moderate(31-60)and severe(>60).All data were analyzed by SPSS25.0 software.Results:1.Baseline clinical characteristics:According to the inclusion and exclusion criteria,a total of 83 samples were included,and the final sample size was 69 cases after a one month follow-up.The average age of BPPV patients was 54.03 years,Male/female prevalence rate 1:2.1.More on the right side than the left side.There were 49(71.0%)cases of posterior semicircular canal BPPV.The median serum 25-OH VitD level on the day after diagnosis of all patients in the group was 14.08ng/ml.After canalith repositioning procedures,there were 43(62.3%)patients with residual dizziness.The median score of DHI for the severity of RD was 10.Patients with RD were followed up for 1 month and found that the median duration of RD was 7 days.2.Serum 25-OH VitD levels(p=0.005)were statistically different in different types of BPPV patients.Based on score of DHI,patients diagnosed with BPPV,were devided into three groups.The serum 25-OH VitD levels(p<0.001)of the three groups of mild,moderate and severe were significantly difference.there was a significantly difference between serum 25-OH VitD(p<0.001)levels in patients with and without RD.The serum25-OH VitD levels(p<0.001)of different groups of RD duration were significantly different.The serum 25-OH VitD levels(p<0.001)of different groups of RD duration were significantly different.3.The correlation was significant negative between the level of serum 25-OH VitD and the severity of BPPV,the presence or absence of residual dizziness,the duration of residual dizziness,and the severity score.4.Right side involvement,duration of BPPV,DHI score at BPPV visit and the level of serum 25-OH VitD are the influencing factors for residual dizziness.Univariate and multivariate logistic regression analysis found that the level of serum 25-OH VitD was a protective factor for RD,and the severity of BPPV was an independent risk factor for RD.5.Based on the ROC curve,the projected optimal cutoff value of serum 25-OH VitD levels as an indicator for the diagnosis of RD was 13.68 ng/m L,which yielded a sensitivity of 92.3% and a specificity of 65%,with an area under the curve of 0.851(95%CI,0.763-0.938).the projected optimal cutoff value of severity score for BPPV as an indicator for the diagnosis of RD was 37,which yielded a sensitivity of 72% and a specificity of 81%,with an area under the curve of 0.792(95% CI,0.669-0.915).Conclusions:1.The level of serum 25-OH VitD is a protective factor for RD,and BPPV severity score is a risk factor.2.The level of serum 25-OH VitD and BPPV severity score can predict the occurrence of RD.serum 25-OH VitD levels may have early screening for RD after reset in patients with BPPV.BPPV severity score is better for diagnosis.