The Clinical Analysis Of Meniere's Disease And Benign Positional Paroxysmal Vertigo

Objective:To analysis the clinical features and videonystagmograph(VNG)of two most common aural vertigo deseases of Meniere' s disease and Benign Positional Paroxysmal Vertigo(BPPV).Hope to provide the reference to the disease diagnosis,differential diagnosis,treatment and prognosis judgement.Methods:40 patients diagnosed by Meniere's disease and 55 patients diagnosed BPPV of otolaryngology head and neck surgery clinics of Sir Run Run Shaw Hospital of Medical College of Zhejiang University from October 2016 to October 2017.Own and contrast analysis the clinical characteristics and results of VNG of the two kinds of disease.Results:Unilateral Meniere's disease:26 cases and the bilateral Meniere's disease:14 cases.In the age group of both and unilateral and bilateral Meniere's disease,there are no statistical significance.In the group of history length of unilateral and bilateral Meniere's disease,we find that with the extension of medical history of bilateral Meniere's disease accounted for the onset of the ratio of the total number has increasing trend.But there are no statistical significance between each group.In the unilateral eMniere's disease patients,Meniere's disease involved ear is regarded as the affected side group and Meniere's disease un-involved ear as the normal side group.The caloric test results of 26 cases of unilateral Meniere's disease are that the group of affected side:21 cases with abnormal semicircular canal paresis(CP),5 cases with normal CP and the group of normal side:5 cases with abnormal CP,21 cases with normal CP.The two groups had statistical significance with statistical analysis results:P<0.001.With stratified by age of CP result of 40 cases of Meniere' s disease,there are no statistical significance between each age groups.With the gender group of CP result,5 male cases with normal result,13 male cases with abnormal result,5 female cases with normal result,17 male cases with abnormal result.There is no statistical significance between the two groups.For 55 cases of BPPV:51 patients with unilateral BPPV and 4 cases with bilateral BPPV.In the unilateral BPPV patients,BPPV involved ear is regarded as the affected side group and BPPV un-involved ear as the normal side group.The caloric test results of 51 cases of unilateral BPPV are that the group of affected side:16 cases with abnormal CP,35 cases with normal CP and the group of normal side:10 cases with abnormal CP,31 cases with normal CP.There is no statistical significance between the two groups.With stratified by age of CP result of 55 cases of BPPV,there are no statistical significance between each age groups.Statistical analysis of CP result between 40 cases of Meniere's disease and 55 cases of BPPV,P<0.01,there is statistical significance.Clinical symptoms analysis between 40 cases of Meniere's disease and 55 cases of BPPV is that Meniere's disease group:38 cases with cochlear symptoms which included hearing loss,tinnitus,aural fullness and so on,2 cases without cochlear symptoms;BPPV:38 cases with cochlear symptoms,2 cases without cochlear symptoms.The two groups had statistical significance with statistical analysis results:P<0.001.Conclusion:Bilateral Meniere's disease is not uncommon and the emerging rate has increasing trend with the extension of history.Cochlear symptoms,for instance hearing loss and ear stuffy,tinnitus,also are of great significance to the differential diagnosis of Meniere's disease with BPPV.Vestibular function examination plays an important role in the diagnosis of peripheral vestibular vertigo.The caloric test had clinical application value to the diagnosis and judgment of abnormal side of Meniere' s disease and the differential diagnosis with BPPV.However,the Caloric test has little significance for BPPV patient,which may because of the little effect of temperature on otolith floating in the endolymph and thus on the flow of endolymph and nystagmus.