Recurrence in Benign Paroxysmal Positional Vertigo: A Large, Single-Institution Study

Objective: To report rates of recurrence in benign paroxysmal positional vertigo (BPPV) and associated patient and disease factors. Study Design: Retrospective chart review. Setting: Single high-volume otology practice. Patients: Patients diagnosed with BPPV from 2007 to 2016 with documented resolution of symptoms. Intervention: Diagnostic and particle repositioning maneuvers for BPPV. Main Outcome Measures: BPPV recurrence, time to recurrence, and ear(s) affected at recurrence. Results: A total of 1,105 patients meeting criteria were identified. Of this population, 37% had recurrence of BPPV in either ear or both ears. Overall same-ear recurrence rate was 28%; 76% of recurrences involved the same ear(s) as initial presentation. Recurrences that occurred after longer disease-free intervals were more likely to involve the opposite ear than early recurrences ( p = 0.02). Female sex (40.4% versus 32.7%, p = 0.01) and history of previous BPPV (57.5% versus 32.4%, p < 0.0005) were associated with increased risk of recurrence, while history of Menière's disease, diabetes mellitus, and traumatic etiology were not. Approximately, half (56%) of recurrences occurred within 1 year of resolution. Conclusions: A large single-institution study of recurrence in BPPV is presented along with Kaplan–Meier disease-free survival curves. Female sex and history of previous BPPV were associated with increased recurrence, while previously suspected risk factors for recurrence including history of Menière's disease, diabetes, and trauma were not. Remote recurrence is more likely to involve the contralateral ear than early recurrence. These data solidify the expected course of treated BPPV allowing for improved clinical care and patient counseling.