DISCUSSION
Although the ages of the patients included in our study ranged between
18-65, it was found that a significant portion of the patients was in
the 44-55 age range (35.8%, n=24) 12,13. In line with
the literature, it was found that the incidence of BPPV in our study
increased with increasing age 14. Given the gender
distribution of patients, there was no statistically significant
difference between the two genders. Although results similar to our
study have been reported in the literature, some studies have reported
that BPPV is more common among women than in men12,14. Considering the symptoms of the patients, the
presence of nausea in 67.2% (n=45), vomiting in 23.9% (n=16), and
history of fall in 7.5% (n=5) of the patients show similar rates with
the studies in the literature 15,16. These symptoms
arising when the vestibular system is affected are evaluated as the
results of BPPV.
In accordance with the literature, the diagnosis was determined to be
posterior canal canalolithiasis in 43.3% (n=29) of the patients
diagnosed with BPPV in our study 3. The highest
incidence of BPPV in the posterior canal is due to its anatomical
position. In addition to the posterior canal canalolithiasis group,
11.9% (n=8) of the cases were diagnosed with posterior canal
cupulolithiasis, 20.9% (n=14) with lateral canal canalolithiasis, and
23.9% (n=16) with lateral canal cupulolithiasis. The rate of diagnosis
of lateral canal pathologies (canalolithiasis/cupulolithiasis) is found
to be very low in some studies in the literature17,18, while in some studies, the rate of diagnosis of
lateral canal pathologies (canalolithiasis/cupulolithiasis) is found to
be much higher, as in our study. These high rates are believed to be
associated with the use of the VNG for the diagnosis of BPPV in recent
years. The use of VNG prevents missing lateral canal pathologies. Thus,
higher rates of diagnosis are achieved compared to previous years3,4. The incidence of hearing loss in 19.4% (n=13)
and tinnitus in 26.9% (n=18) of the patients in our study is consistent
with the studies in the literature. However, these symptoms are
considered not to be directly associated with BPPV 19.
In line with the literature, it was found in our study that there was a
statistically significant decrease in the post-repositioning scores of
DHI and all subscales of the scale (physical, functional and emotional)20. It is thought that the considerable reduction in
the negative feelings of individuals is caused by the efficacy of the
repositioning maneuvers on the BPPV pathology .
In our study, there was a statistically significant decrease in the
post-repositioning dizziness intensity (VAS) scores. When the literature
is reviewed, the statistically significant decrease in the VAS scores in
various studies including BPPV patients diagnosed with posterior canal
canalolithiasis 21, patients diagnosed with BPPV19 and patients with subjective BPPV is similar to our
study.
The patients in our study got the highest scores from the functional,
emotional and physical subscales of the DIH before and after
repositioning maneuvers, respectively. Contrary to our study, Whitney et
al. reported that there was no statistically significant difference
among the subscale scores of the DIH in patients diagnosed with BPPV22. In some of the studies, the highest scores taken
from the subscales were physical, functional and emotional groups,
respectively 20. Some of the studies reported that
patients with BPPV got the pre- and post-repositioning highest scores
from the physical subscale 23. When we compared the
scores obtained from the subscales of the DIH in the literature review,
similar and different aspects were determined with our study. In the
literature, it is thought that the differences in the scores obtained
from the subscales of the DIH may be related to the differences of the
regions where the studies were conducted and the sociocultural levels
and educational levels of patients.
It was found in our study that the total mean scores obtained from the
VDI-QOL and VDI-SS increased statistically significantly after
repositioning maneuvers. The fact that the study by Kulcu et al. (2008)
found statistically significant positive improvements in quality of life
of individuals diagnosed with BPPV after repositioning maneuvers and
vestibular rehabilitation exercises supports our study .
Given the literature, it was found that patients diagnosed with BPPV
showed statistically significant positive improvements in their vertigo
symptoms after repositioning maneuvers and vestibular rehabilitation
exercises. These results demonstrate the strong effect of reposition
maneuvers on quality of life and vertigo symptoms24,25.