Benign paroxysmal positional vertigo after dental surgery


We investigated the relationship between dental and maxillofacial surgery and benign paroxysmal positional vertigo (BPPV). BPPV represents the most frequent cause of vertigo of labyrinthine origin. BPPV has been reported following surgical trauma from various surgical interventions, regarding anatomical site and technical execution. A surgical origin is, in many cases, supported by the temporal relation to the surgical intervention as well as by the clinical picture. We considered eight BPPV cases of suspected iatrogenic origin focusing our attention on dental surgery with particular reference to surgical extraction of included teeth through rotating tools. The cases taken into account had no other inner ear disease and BPPV risk indicator. We conclude that dental surgery is a risk factor for BPPV.

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  1. 1.

    Andaz C, Whittet HB, Ludman H (1993) An unusual cause of benign paroxysmal positional vertigo. J Laryngol Otol 107:1153–1154

    PubMed  CAS  Google Scholar 

  2. 2.

    Atacan E, Serranoglu L, Genc A, Kaya S (2001) Benign paroxysmal positional vertigo after stapedectomy. Laringoscope 111:1257–1259

    Article  CAS  Google Scholar 

  3. 3.

    Black FO, Lilly DJ, Perterka RJ, Fowler LP, Simmons FS Vestibular-ocular and vestibular-spinal function before and after cochlear implant surgery. Ann Otol Rhynol Laryngol 96 (suppl 128):106–109

  4. 4.

    Cope S, Ryan GM (1959) Cervical and otolith vertigo. J Laryngol Otol 73:113

    PubMed  Article  CAS  Google Scholar 

  5. 5.

    Di Girolamo S, Fetoni AR, Di Nardo W, Paludetti G (1999) An unusual complication of cochlear implant: benign paroxysmal positional vertigo. J Laryngol Otol 113:922–923

    PubMed  CAS  Google Scholar 

  6. 6.

    Dix MR, Hallpike CS (1952) The pathology, symptomatology and diagnosis of the vestibular system. Ann Otol Rhynol Laryngol 61:987–1016

    CAS  Google Scholar 

  7. 7.

    Donaldson JA, Duckert LG, Lambert PM, Rubel EW (1992) Surgical anatomy of the temporal bone 4th edn. Raven Press, New York p 275

    Google Scholar 

  8. 8.

    Epley JM (1992) The canalith repositioning maneuver for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 107:399–404

    PubMed  CAS  Google Scholar 

  9. 9.

    Fitzgerald G, Hallpike CS (1942) Studies in human vestibular function: 1. Observation on the directional preponderance of caloric nystagmus resulting from cerebral lesions. Brain 65:115

    Article  Google Scholar 

  10. 10.

    Flanagan D (2004) Labyrinthine concussion and positional vertigo after osteotome site preparation. Implant Dent 13(2):129–132

    PubMed  Google Scholar 

  11. 11.

    Galli M, Petracca T, Minozzi F, Gallottini L (2004) Complications in implant surgery by Summer’s technique: benign paroxysmal positional vertigo (BPPV). Minerva Stomatol 53(9):535–541

    PubMed  CAS  Google Scholar 

  12. 12.

    Hall SF, Ruby RR, McClure JA (1979) The mechanics of benign paroxysmal vertigo. J Otolaryngol 8:151–158

    PubMed  CAS  Google Scholar 

  13. 13.

    Hughes CA, Proctor L (1997) Benign paroxysmal positional vertigo. Laringoscope 107:607–613

    Article  CAS  Google Scholar 

  14. 14.

    Iorio N, Sequino L, Chiarella G, Cassandro E (2004) Database of benign paroxysmal nistagmus (PPNy). Acta Otorhinolaryngol Ital 24/3:125–129

    Google Scholar 

  15. 15.

    Kaplan DM, Attal U, Kraus M (2003) Bilateral benign paroxysmal positional vertigo following a tooth implantation. J Laryngol Otol 117:312–313

    PubMed  Article  Google Scholar 

  16. 16.

    Katsarkas A (1999) Benign paroxysmal positional vertigo (bppv): idiopathic versus post-traumatic. Acta Otolaryngol 119:745–9

    PubMed  Article  CAS  Google Scholar 

  17. 17.

    Leopardi G, Chiarella G, Serafini G, Pennacchi A, Bruschini L, Brizi S, Tasca I, Simoncelli C, Cassandro E (2003) Paroxysmal positional vertigo: short and long term clinical-methodological analysis of 794 patients. Acta Otorhinolaryngol Ital 23/3:155–160

    Google Scholar 

  18. 18.

    McClure JA (1985) Horizontal canal BPV. J Otolaryngol 14:30

    PubMed  CAS  Google Scholar 

  19. 19.

    Nigam A, Moffat DA, Varley EW (1989) Benign paroxysmal positional vertigo resulting from surgical trauma. J Laryngol Otol 103:203–204

    PubMed  CAS  Google Scholar 

  20. 20.

    Pagnini P, Nuti D, Vannucchi P (1989) Benign paroxysmal vertigo of the horizontal canal. ORL 51:161

    PubMed  CAS  Article  Google Scholar 

  21. 21.

    Parnes LS, McClure JA (1992) Free-floating endolymph particles: a new operative finding during posterior semicircular canal occlusion. Laryngoscope 102(9):988–992

    PubMed  Article  CAS  Google Scholar 

  22. 22.

    Pennarrocha M, Perez H, Garcia A, Guarinos J (2001) Benign paroxysmal positional vertigo as a complication of osteotome expansion of the maxillary alveolar ridge. J Oral Maxillofac Surg 59(1):106–107

    Article  Google Scholar 

  23. 23.

    Perez Garrigues H, Mateos Fernandez M, Penarrocha M (2001) Benign paroxysmal positional vertigo secondary to surgical maneuvers on superior maxilla. Acta Otorinolaringol Esp 52:343–346

    CAS  Google Scholar 

  24. 24.

    Rodríguez Gutiérrez C, Rodríguez Gómez E (2007) Positional vertigo afterwards maxillary dental implant surgery with bone regeneration. Med Oral Patol Oral Cir Bucal 12(2):E151–E153

    PubMed  Google Scholar 

  25. 25.

    Schuknecht HF (1969) Cupulolithiasis. Arch Otolaryngol 90:113–126

    Google Scholar 

  26. 26.

    Semont A, Freyss G, Vitte E (1988) Curing the BPPV with a liberatory maneuver. Adv Otorhinolaryngol 42:290–293

    PubMed  CAS  Google Scholar 

  27. 27.

    Vannucchi P, Giannoni B, Pagnini P (1997) Treatment of horizontal semicircular canal benign paroxysmal positional vertigo. J Vestib Res 7(1):1–6

    PubMed  Article  CAS  Google Scholar 

  28. 28.

    Welling DB, Parnes LS, O’Brien B, Bakaletz LO, Brackmann DE, Hinojosa R (1997) Particulate matter in the posterior semicircular canal. Laryngoscope 107(1):90–94

    PubMed  Article  CAS  Google Scholar 

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The authors would thank Mrs. Antonella De Be for her precious contribution.

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Correspondence to Giuseppe Chiarella.

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Chiarella, G., Leopardi, G., De Fazio, L. et al. Benign paroxysmal positional vertigo after dental surgery. Eur Arch Otorhinolaryngol 265, 119–122 (2008).

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  • Benign paroxysmal positional vertigo
  • Dental surgery
  • Surgical trauma