To Investigate The Prognosis-related Influencing Factors Of The Benign Paroxysmal Positional Vertigo’s Residual Symptoms

Objective To investigate the prognosis-related influencing factors of the residual symptoms after the canalith repositioning procedure(CRP) for the benign paroxysmal positional vertigo(BPPV).Methods From May 2013 to August 2014 in the otolaryngology department of the Second Hospital affiliated to Dalian Medical University,one hundred and forty-nine patients who were diagnosed with BPPV and treated by CRP but still have residual symptoms were enrolled in our study, in which,the residual symptoms include the relieved vertigo and typical vertigo disappeared but still with a head befuddlement,scalp numbness, cerebellum heaviness, and slight sense of rotation about the scenary or body, etc, then to make a follow-up within 6 months irregularly about the tendency of their residual symptoms’ self-healing,and respectively record in their gender, age, type of vertigo, medication history and chronic diseases such as diabetes, hypertension, heart disease, hyperlipidemia, ischemic encephalopathy, and so on. The sex was divided into two groups,male and female; the age groups was according to the new age segmentation rule proposed by the World Health Organization of the United Nations, that is, patients who were ≤ 44 years old were divided into the young group, who were ≥ 45 years old and ≤ 59 years old were divided into the middle-aged group, aged 60 to 74 into the young-elderly group, age from 75 to 89 into the elderly group; the dizziness type groups were divided into 5 groups according to the results of videonystagmography(VNG), that is, the type of the left posterior semicircular canal(LPC), the right posterior semicircular canal(RPC), the left horizontal semicircular canal(LHC), the right horizontal semicircular canal(RHC) and the mixed semicircular canal(MC), in which, the MC refers to the fact that two semicircular canals were affected by the same or different sides at the same time; the medical history and complications about the chronic diseases were divided into two groups according to whether or not, then compare all of them,and use the binary Logistic regression to analyse the residual symptoms’ related influencing factors and risk factors about BPPV after the treatment of CRP.Results For the self-healing rate of the residual symptoms, the difference between the female group( 42.0%) and the male group( 70.0%) is significant( χ2 = 7.521, p =0.006), and the sex groups are negatively correlated with the prognosis of the residual symptoms( r =-0.225, p =0.006); the age groups can be incorporated into the binary Logistic regression analysis equation, the middle-aged group is harder to heal by itself than the young group( OR = 26.431, 95% CI = 1.782 ~ 391.985, p = 0.017), the young elderly group is harder to heal by itself than the young group( OR = 674.689,95% CI = 9.250 ~ 49209.723, p =0.003), the elder age is a risk factor for the residual symptoms’ prognosis; the differences in the 5 groups of vertigo are not significant( χ2 =3.369, p = 0.498); there is no significant difference in the drug history groups( χ2=0.025, p = 0.869); the self-healing rate are significantly different between the ischemic encephalopathy groups( χ2 = 23.848, p < 0.05), and the ischemic encephalopathy groups showed a negative correlation with the prognosis of the residual symptoms groups( r =-0.400, p < 0.05); the self-healing rate of the residual symptoms are significantly different in the heart disease groups( χ2 = 4.084, p =0.043), and the heart disease groups are negatively correlated with the prognosis of the residual symptoms( r=-0.166, p =0.044); there is not significant difference in the self-healing rate of the hyperlipidemia groups’ residual symptoms( χ2 = 0.321, p = 0.571); suffering from hypertension( OR = 177.864, 95% CI =10.121 ~ 3125.822, p < 0.05) and diabetes( OR = 69.025, 95% CI= 6.854 ~ 695.124, p < 0.05) are the risk factors which influencing the prognosis of the residual symptoms.Conclusion For the 149 BPPV patients who still have residual symptoms after the treatment of specifical CRP, the residual symptoms in the elderly females and patients suffering from the hypertension, diabetes, heart disease and ischemic encephalopathy are not easy to heal by itself, in which, the older and the fact suffering from the hypertension and diabetes are the risk factors influencing the prognosis of the residual symptoms; the vertigo type, medication history and hyperlipidemia have no significant correlation with the prognosis of the residual symptoms.