Comparison of otolith functions before and after repositioning maneuvers in benign paroxysmal positional vertigo patients

Benign ParoxysmalPositional Vertigo (BPPV) is a disease that is triggered by the angular movements of the head and is characterized by sudden-onset short-lasting episodes.While the pathophysiology of BPPV is usually idiopathic, dizziness, nausea, and imbalance symptoms occur as a result of the migration of otoconia from the utricular maculae to the semicircular canal as a result of head trauma, viral infection, or age-related changes in the otolithic membrane.As a vestibular test battery, VEMP is an EMG recording method that is used to assess otolith organ functions. In this study, it was aimed to investigate the effects of repositioning maneuvers on otolith organ functions in patients with BPPV by using c-VEMP and o-VEMP tests before and after repositioning maneuvers. The study included 33 individuals between the ages of 18 to 60 who were diagnosed with BPPV and met the inclusion criteria.All patients were examined using DHI, VAS, VNG, c-VEMP, and o-VEMPtests. While 18 of the patients (54.55%) were female, 15 (45.45%) were male. The mean age of the patients was 48±6.81. The DVI total and subscale scores of the patients before the repositioning maneuvers were significantly higher than their scores after the repositioning maneuvers (p<0.05). The VAS scores of the patients before the repositioning maneuvers were significantly higher than their scores after the repositioning maneuvers (p<0.05). In both the c-VEMP and o-VEMP assessments of the patients, there was no significant difference in the presence of waves on the pathologic and normal sides between before and after the repositioning maneuvers (p>0.05). Additionally, in the same assessments on the pathologic and normal sides, there was also no significant difference between the patients' P1 latency, N1 latency, P1-N1 interpeak latency, orasymmetry ratio values measured before and after the repositioning maneuvers (p>0.05).In both the c-VEMP and o-VEMP assessments of the patients on the pathologic side, their P1-N1interpeakamplitudevalues after the repositioning maneuvers were significantly higher than their values before the repositioning maneuvers (p<0.05). Before the repositioning maneuvers, the c-VEMP and o-VEMP P1-N1 interpeak amplitude values of the patients on the normal side were significantly higher than their values on the pathologic side(p<0.05). According to the results of our study, it was concluded that the VEMP results of BPPV patients can be affected by utricular and saccular macular degeneration. Moreover, VEMP examination is recommended for the post-repositioning follow-up of BPPV patients.