Received July 1, 2015 Revised August 12, 2015 Accepted August 28, 2015 Address for correspondence Dae Bo Shim, MD, PhD Department of Otorhinolaryngology, Myongji Hospital, Seonam University College of Medicine, 55 Hwasu-ro 14beon-gil, Deokyang-gu, Goyang 10475, Korea Tel +82-31-810-5451 Fax +82-31-969-0500 E-mail lovend77@gmail.com Background and ObjectivesZZThe purpose of this study was to identify the clinical characteristics of benign paroxysmal positional vertigo (BPPV) occurring after head trauma by comparing them to those of idiopathic BPPV (i-BPPV). Subjects and MethodZZWe analyzed retrospectively 820 patients diagnosed with BPPV. Patients were classified into two groups: post-traumatic BPPV (t-BPPV) group and i-BPPV group. We compared the clinical characteristics (age, sex, affected side, duration of vertigo, types of BPPV) and treatment outcomes between the two groups. ResultsZZThe study included 497 patients with i-BPPV and 56 patients with t-BPPV. There were no differences in age distribution and the affected side. The t-BPPV group had greater male preponderance (48%) than the i-BPPV group (24%) did and longer duration of vertigo compared to i-BPPV group (p=0.028). In addition, the t-BPPV group demonstrated higher horizontal canal BPPV/posterior canal BPPV ratio (t-BPPV vs. i-BPPV=0.54 vs. 0.20, p=0.008). Although the results of a single treatment outcome did not differ between the two groups (p=0.127), there was a greater tendency for the t-BPPV group to receive a higher number of therapeutic maneuvers until resolution than for the i-BPPV group (p=0.056). Recurrence rate also did not differ between the two groups (p=0.125). ConclusionZZThe clinical features did not differ significantly between the two groups, although t-BPPV demonstrated a tendency of low therapeutic efficacy and high recurrence rates compared to i-BPPV. This information may be helpful for clinicians in counseling and managing patients with t-BPPV. Korean J Otorhinolaryngol-Head Neck Surg 2015;58(12):836-40