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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2022; 26(04): e666-e670
DOI: 10.1055/s-0041-1730992
Original Research

Therapeutic Effect of the Correction of Vitamin D Deficiency in Patients with Benign Paroxysmal Positional Vertigo. A Randomized Clinical Trial

Jimena Mancera Sánchez 
1   Ear Nose and Throat Department, Instituto Nacional de Rehabilitación, Mexico City, Mexico
,
Juan Carlos Hernaiz Leonardo
1   Ear Nose and Throat Department, Instituto Nacional de Rehabilitación, Mexico City, Mexico
,
Julia Kioko Ishiwara Niembro
2   Department of Otoneurology, Instituto Nacional de Rehabilitacion Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
,
Juan Carlos Lesser
1   Ear Nose and Throat Department, Instituto Nacional de Rehabilitación, Mexico City, Mexico
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Abstract

Introduction Benign paroxysmal positional vertigo (BPPV) appears during the same age group in which vitamin D and calcium deficiencies are evident. Vitamin D deficiency could predispose to BPPV, since these two entities share a demineralization process.

Objective To establish the otological impact of vitamin D supplementation in patients with its deficiency who suffer from BPPV.

Methods This was a randomized clinical trial. A total of 35 patients with vitamin D deficiency (< 30 ng/ml) and BPPV were divided into 2 groups: Group 1 (control group): treatment with repositioning maneuvers; and Group 2: treatment with repositioning maneuvers and vitamin D supplementation.

Results A follow-up of between 6 and 13 months and a log rank test revealed that the probability of recurrence between the experimental groups was significantly different, with group 2 having a decreased recurrence of vertigo (p = 0.17). Scores in the Dizziness Handicap inventory (DHI) in patients treated with vitamin D supplementation were smaller (10 ± 9) when compared with a score of 36 ± 9 in the control group.

Conclusion Plasmatic values of 25-hydroxyvitamin D have an impact in patients with BPPV, who present an improvement in their quality of life when their vitamin D levels are replaced with supplementation. Benign paroxysmal positional vertigo could stop being perceived as a purely otologic disease.

Keywords

benign paroxysmal positional vertigo - deficiency - vitamin D


Publication History

Received: 15 July 2020

Accepted: 14 February 2021

Article published online:
13 April 2022

© 2022. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Silva C, Amorim AM, Paiva A. Benign paroxysmal positional vertigo--a review of 101 cases. Acta Otorrinolaringol Esp 2015; 66 (04) 205-209
    CrossrefPubMedSearch in Google Scholar
  • 2 Davies RA, Luxon LM. Dizziness following head injury: a neuro-otological study. J Neurol 1995; 242 (04) 222-230
    CrossrefPubMedSearch in Google Scholar
  • 3 Talaat HS, Abuhadied G, Talaat AS, Abdelaal MS. Low bone mineral density and vitamin D deficiency in patients with benign positional paroxysmal vertigo. Eur Arch Otorhinolaryngol 2015; 272 (09) 2249-2253
    CrossrefPubMedSearch in Google Scholar
  • 4 Nunez RA, Cass SP, Furman JM. Short- and long-term outcomes of canalith repositioning for benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 2000; 122 (05) 647-652
    CrossrefPubMedSearch in Google Scholar
  • 5 Sakaida M, Takeuchi K, Ishinaga H, Adachi M, Majima Y. Long-term outcome of benign paroxysmal positional vertigo. Neurology 2003; 60 (09) 1532-1534
    CrossrefPubMedSearch in Google Scholar
  • 6 Brandt T, Huppert D, Hecht J, Karch C, Strupp M. Benign paroxysmal positioning vertigo: a long-term follow-up (6-17 years) of 125 patients. Acta Otolaryngol 2006; 126 (02) 160-163
    CrossrefPubMedSearch in Google Scholar
  • 7 Talaat HS, Kabel AM, Khaliel LH, Abuhadied G, El-Naga HA, Talaat AS. Reduction of recurrence rate of benign paroxysmal positional vertigo by treatment of severe vitamin D deficiency. Auris Nasus Larynx 2016; 43 (03) 237-241
    CrossrefPubMedSearch in Google Scholar
  • 8 Jeong SH, Kim JS, Shin JW. et al. Decreased serum vitamin D in idiopathic benign paroxysmal positional vertigo. J Neurol 2013; 260 (03) 832-838
    CrossrefPubMedSearch in Google Scholar
  • 9 Büki B, Ecker M, Jünger H, Lundberg YW. Vitamin D deficiency and benign paroxysmal positioning vertigo. Med Hypotheses 2013; 80 (02) 201-204
    CrossrefPubMedSearch in Google Scholar
  • 10 Sheikhzadeh M, Lotfi Y, Mousavi A, Heidari B, Monadi M, Bakhshi E. Influence of supplemental vitamin D on intensity of benign paroxysmal positional vertigo: A longitudinal clinical study. Caspian J Intern Med 2016; 7 (02) 93-98
    PubMedSearch in Google Scholar
  • 11 Walther LE, Westhofen M. Presbyvertigo-aging of otoconia and vestibular sensory cells. J Vestib Res 2007; 17 (2-3): 89-92
    CrossrefPubMedSearch in Google Scholar
  • 12 Lins U, Farina M, Kurc M. et al. The otoconia of the guinea pig utricle: internal structure, surface exposure, and interactions with the filament matrix. J Struct Biol 2000; 131 (01) 67-78
    CrossrefPubMedSearch in Google Scholar
  • 13 Parnes LS, Agrawal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ 2003; 169 (07) 681-693
    Search in Google Scholar
  • 14 Jeong SH, Choi SH, Kim JY, Koo JW, Kim HJ, Kim JS. Osteopenia and osteoporosis in idiopathic benign positional vertigo. Neurology 2009; 72 (12) 1069-1076
    CrossrefPubMedSearch in Google Scholar
  • 15 Vibert D, Sans A, Kompis M. et al. Ultrastructural changes in otoconia of osteoporotic rats. Audiol Neurotol 2008; 13 (05) 293-301
    CrossrefPubMedSearch in Google Scholar
  • 16 Zucca G, Valli S, Valli P, Perin P, Mira E. Why do benign paroxysmal positional vertigo episodes recover spontaneously?. J Vestib Res 1998; 8 (04) 325-329
    CrossrefPubMedSearch in Google Scholar
  • 17 Yu S, Liu F, Cheng Z, Wang Q. Association between osteoporosis and benign paroxysmal positional vertigo: a systematic review. BMC Neurol 2014; 14: 110
    CrossrefPubMedSearch in Google Scholar
  • 18 Jang YS, Kang MK. Relationship between bone mineral density and clinical features in women with idiopathic benign paroxysmal positional vertigo. Otol Neurotol 2009; 30 (01) 95-100
    CrossrefPubMedSearch in Google Scholar
  • 19 Bhattacharyya N, Baugh RF, Orvidas L. et al; American Academy of Otolaryngology-Head and Neck Surgery Foundation. Clinical practice guideline: benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 2008; 139 (05, Suppl 4): S47-S81
    CrossrefPubMedSearch in Google Scholar
  • 20 Aguilar del Rey FJ. Protocolo de tratamiento de la deficiencia de vitamina D. [Protocol of treatment of vitamin D deficiency] Med Clin (Barc) 2014; 142 (03) 125-131
    CrossrefPubMedSearch in Google Scholar