Risk Factors For Recurrence Of Benign Paroxysmal Positional Vertigo After Reduction Of Otoliths: A Meta Analysis

Objective:Benign paroxysmal positional vertigo is a common peripheral vertigo disease.The otolith reduction method can remove the fallen otolith fragments back into the utricle.It is the most effective method for the treatment of BPPV,but the symptoms of BPPV often recur after significant relief.At present,many literatures have explored the risk factors associated with BPPV recurrence,but the results are not consistent,and there is no consensus on the correlation.This study aims to use Meta-analysis to evaluate several currently recognized risk factors,to explore whether it has clinical significance,and to provide evidence-based medicine evidence for the prognosis of BPPV.Methods:Computer search of PubMed,Embase,OVID,Springer,Proquest,China Biomedical Literature Database(CBM),Wanfang,CNKI,etc.,and all relevant Chinese and English literatures for retrieving BPPV recurrence risk factors.According to the inclusion and exclusion criteria,the included literature was meta-analyzed using Revman 5.3 software.The study was a two-category variable.The OR value and 95% CI were used to express the effect amount.The searching time ended up to May,2018.Results:Strictly according to the inclusion and exclusion criteria,the full text of the literature was read one by one,and a total of 21 articles were finally included,with a total of 5997 samples.Meta analysis results show: the recurrence after Otolith reduction of BPPV inpatients with the hyperlipidemia,Meniere's disease and head trauma increased significantly,compared to the patients without the hyperlipidemia,Meniere's disease and head trauma,difference was statistically significant[OR=1.74,95%CI(1.14,2.65),P=0.01;OR=4.57,95%CI(2.78,7.52),P?0.01;OR=1.44,95%CI(1.03,2.01),P?0.05].There was no significant difference in the recurrence after Otolith reduction of BPPV in patients with diabetes,migraine and sudden deafness compared without diabetes,migraine and sudden deafness [OR=1.14,95%CI(0.84,1.54),P?0.05;OR=0.99,95%CI(0.66,1.47),P?0.05;OR=0.63,95%CI(0.15,2.58),P?0.05].Conclusion:According to the research of this paper,it is concluded:(1)BPPV with hyperlipidemia,Meniere's disease,and head trauma is a risk factor for BPPV recurrence after otolith reduction.(2)BPPV with diabetes,migraine,and sudden deafness was not associated with recurrence after BPPV otolith reduction.(3)There are inadequacies in the results of this study.The specific situation is not specifically analyzed.There may be certain biases.In the future,it is necessary to design rigorous,large-sample,high-quality tests to further clarify the reliability of relevant factors.