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Benign paroxysmal positional vertigo and asymmetric hearing loss: is the worst hearing ear likely to suffer from otoconial displacement?

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Benign paroxysmal positional vertigo (BPPV) may be found in patients complaining of hearing disorders. The aim of our investigation was to describe audiological findings in BPPV patients, focusing on subjects with asymmetric hearing loss (AHL), to better understand whether otoconial displacement may occur preferentially in the worst hearing ear.

Methods

A prospective study was performed on 112 BPPV patients. We divided the sample into subjects who suffered from AHL (G1) and patients with did not (G2). Data regarding vestibular symptoms, tinnitus, migraine, antivertigo drug therapy, and vascular risk factors were collected.

Results

Out of 30 AHL subjects, 83.33% of them were affected by sensorineural hearing loss (SNHL) in at least one ear, with a significant difference in the distribution of hearing loss type between groups (p = 0.0006). In 70% of cases, the ear affected by BPPV was the one with the worst hearing threshold (p = 0.02); threshold asymmetry predicted BPPV in the worst hearing ear (p = 0.03). The predictability depended neither on the hearing threshold gap between ears nor the severity of the hearing threshold in the worst ear (p > 0.05). No differences in vascular risk factors between groups were observed (p > 0.05). We evidenced a moderate correlation between age and hearing threshold (ρ = 0.43). Age did not result a predictive factor for residual dizziness or BPPV in the worst ear (p > 0.05).

Conclusions

Our study supports the likelihood of an otoconial displacement in the worse hearing ear in BPPV patients. Clinicians should start testing the worst hearing ear when managing AHL patients with suspected BPPV.

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Data availability

The data that support the findings of this study are available on request from the corresponding author.

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Funding

This research received no external funding.

Author information

Authors and Affiliations

  1. Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata (BiND), Sezione di Audiologia, Università degli Studi di Palermo, Via del Vespro 129, 90127, Palermo, Italy

    Pietro Salvago & Francesco Martines

  2. Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata (BiND), Sezione di Otorinolaringoiatria, Università degli Studi di Palermo, Via del Vespro 129, 90127, Palermo, Italy

    Angelo Immordino & Francesco Dispenza

  3. UOSD Audiologia, A.O.U.P. “Paolo Giaccone”, Via del Vespro 129, 90127, Palermo, Italy

    Davide Vaccaro

  4. Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127, Palermo, Italy

    Fulvio Plescia

  5. UOC Otorinolaringoiatria, A.O.U.P. “Paolo Giaccone”, Via del Vespro 129, 90127, Palermo, Italy

    Federico Sireci

Authors
  1. Pietro Salvago
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  2. Angelo Immordino
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  3. Davide Vaccaro
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  4. Fulvio Plescia
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  5. Francesco Dispenza
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  6. Federico Sireci
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  7. Francesco Martines
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Corresponding author

Correspondence to Pietro Salvago.

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Informed consent

Informed consent was obtained from all subjects involved in the study.

Ethical approval

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of AOUP “P. Giaccone” Hospital (N°10/2020).

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Salvago, P., Immordino, A., Vaccaro, D. et al. Benign paroxysmal positional vertigo and asymmetric hearing loss: is the worst hearing ear likely to suffer from otoconial displacement?. Eur Arch Otorhinolaryngol 281, 163–170 (2024). https://doi.org/10.1007/s00405-023-08119-1

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  • DOI: https://doi.org/10.1007/s00405-023-08119-1

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