Increased Risk of Benign Paroxysmal Positional Vertigo in Patients With a History of Sudden Sensory Neural Hearing Loss: A Longitudinal Follow-up Study Using a National Sample Cohort

Abstract

To evaluate the association between benign paroxysmal positional vertigo (BPPV) and sudden sensorineural hearing loss (SSNHL) using a national sample cohort from Korea. Data from the years 2002 through 2013 were collected for individuals aged more than or equal to 20 years from the Korean National Health Insurance Service-National Sample Cohort. SSNHL was classified based on the International Classification of Disease-10 (ICD-10) code H91.2. We included only participants who received an audiometry examination and steroid treatment. After exclusion of participants diagnosed with Menière's disease (H81.0), we extracted data for SSNHL patients (n = 4,109) and 1:4-matched controls (n = 16,436). Matching was performed based on age, sex, income, region of residence, and medical history. BPPV was diagnosed with the ICD-10 code H81.1. Among them, we only included the participants who visit more than or equal to two times for BPPV that does not mean recurrent BPPV. The crude and adjusted hazard ratios (HRs) were calculated using Cox proportional hazard models, and the 95% confidence intervals (CIs) were determined. Subgroup analyses were also performed according to age and sex. The rate of BPPV in the SSNHL group (3.8% [157/4,109]) was higher than that in the control group (1.9% [220/16,436], p < 0.001). The adjusted HR of BPPV was 2.90 (95% CI = 2.36-3.56, p < 0.05). After experiencing SSNHL, the rate of BPPV in the SSNHL group was significantly higher for patients with two, three to four, and more than or equal to five visits for BPPV. In the subgroup analyses, a significant association between SSNHL and BPPV was observed regardless of age and sex. The risk of BPPV is greater in patients with SSNHL.