The objective of the present study was to elucidate the prevalence of various forms of benign paroxysmal positional vertigo (BPPV) among the patients with the complaints of dizziness who had applied for the medical aid. The secondary objective was to evaluate the effectiveness of the newly developed algorithm for the diagnostics and treatment of various forms of the disease. A total of 195 patients with the verified BPPD diagnosis were available for the examination. The fraction of the patients visiting the otoneurologist's office with complaints of this conditions is estimated at 17.8%. It was shown that the women suffer from benign paroxysmal positional vertigo 1.8 times more frequently than the men. The mean age of the patients of either sex experiencing this problem is above 50 years. Most of them have idiopathic pathology. The relationship between benign paroxysmal positional vertigo and vascular neurological disorders or inner and middle ear diseases remains to be elucidated. The present study also included the assessment of the effectiveness of the combination of various repositioning maneuvers, self-assisted vestibular gymnastics in the domestic environment, and training in long lying on the unaffected side.
Tinnitus is one of the most common ENT complaints. The peculiarity of this disease is lack of objective measurements. It is hard to monitor evaluation of treatment results. The main reference points, such as the presence or absence of ear noise – are not sufficient to determine this pathology. Also, most of these patients have negative emotions connected with their ear noise. That is why the characteristics of tinnitus and its influence on the quality of life are very individual. Thus, it is advisable to distinguish two components of ear noise: noise itself, as a physical quantity that has amplitude and frequency parameters, and noise, as the main source of subjective suffering of the patient. To determine the characteristics of these two noise components, we used two diagnostic methods: standard noise measurement and a visually analog scale to assess the degree of discomfort caused by ear noise. In current study, we investigated interconnection between tinnitus intensity measured by tinnitus matching and data of visual-analog scale of subjective perception of tinnitus. We evaluated that severity of tinnitus intensity did not correlate with thresholds in tinnitus pitch matching. In addition, with the help of international questionnaire survey SCL-90-R we revealed correlation between subjective noise level and patient’s psycho-emotional condition.
The objective of the present review of the literature is the analysis of the currently available data concerning etiology and pathogenesis of benign paroxysmal positional vertigo (BPPV). The special emphasis is placed on the modern hypotheses of BPPV formation that collectively account for not more than 15% of all known cases of this condition. The best explored are the following causes of benign paroxysmal positional vertigo: vestibular neuronitis, head injuries, and disorders in the middle ear. During the recent years, much attention has been given to the role of disturbances of calcium metabolism and osteoporosis in etiology of benign paroxysmal positional vertigo. It is supposed that pathogenesis of vertiginous attacks can be explained in terms of the canalolithiasis and cupulolithiasis theories.
The study has demonstrated that the course of vestibular rehabilitation of the patients presenting with vestibular neuritis resulted in a significant decrease in the scores of dizziness estimated based on the dizziness handicap inventory and an improvement of dynamic visual acuity in the case of the complete gain recovery as well as in the case of persisting impairment of the gain and the development of sufficient 'covert' saccade. Vestibular rehabilitation was unsuccessful in the patients with persistereduced gain and simultaneous development of 'covert' and 'overt' saccades.
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