Twenty-two years of BPPV: a retrospective analysis of 3785 patients

Twenty-two years of BPPV: a retrospective analysis of 3785 patients. Introduction and aim: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo, with a reported prevalence ranging from 10.7 to 140 per 100.000. We present a retrospective analysis of BPPV cases over twenty-two years in our department to get a better understanding of the BPPV population in Belgium. Material and methods: We performed a retrospective analysis of 3785 BPPV cases between 1995 and 2016 and of 1468 BPPV cases between 2012 and 2016 receiving telephone follow-up assessment 3 days after canal repositioning maneuver. Results: 1140 (30.54%) of the 3785 patients were male (F/M ratio 2.32). The posterior canal was most frequently involved, in 2759 patients (72.89%). 701 patients had horizontal canal BPPV (18.52%), more frequently geotropic (478, 68.2%) than ageotropic (223, 31.8%). Anterior and multiple canal BPPV occurred less frequently, in 155 (4.10%) and 168 (4.4%) of the affected patients, respectively. Follow-up telephone assessment showed complete resolution of the symptoms in 813 of 1468 patients (55.38%). 655 patients had various persistent symptoms, but 126 (8.58%) patients decided to wait for effects of the initial CRM and did not report persistent complaints, and 207 (14.10%) patients with persistent symptoms had no evidence of BPPV at follow-up. Only 322 (21.93%) patients with persistent symptoms tested positive for BPPV at follow-up and received repeat CRM. Conclusions: We present the largest Belgian BPPV cohort to date. Our findings are consistent with previous reports, however a higher percentage of anterior canal BPPV was observed, suggesting previous underestimation of this type.