Evaluation of utricular functions in benign paroxysmal positional vertigo patients and healthy individuals using virtual reality and vestibular evoked myogenic potentials

Objective: The purpose of this study is to explore utricular functions in patients with benign paroxysmal positional vertigo (BPPV) before and after canalith reposition maneuver (CRM) treatment to determine the effect of vestibular information on vertical perception, compare it to the vertical perception of healthy individuals, and calculate the correlation between the test results. Materials and Methods: The study was conducted in 2023 at the Department of Otolaryngology at Başkent University in Ankara, Turkey, with the participation of 26 BPPV-diagnosed patients and 26 healthy individuals. Prior to and following CRM treatment, the patient group received the subjective visual vertical test (SVV), dynamic subjective visual vertical test (DSVV), and ocular vestibular evoked myogenic potential test (oVEMP). SVV and DSVV tests were applied to the control group. Statistical results were analyzed with IBM SPSS Statistics Base 25.0 (IBM SPSS Statistics for Windows, IBM Corp. Released 25.0.0, Armonk, NY: IBM Corp.). For statistical significance, a p-value below 0.05 was considered significant. Results: The study's participants included 26 patients with an average age of 41.15±14,46 and 26 healthy individuals with an average age of 35.77±12,77. When the DSVV values before and after the treatment were compared in the patient group, a significant difference was found (p<0.05), but no significant difference was found when the SVV values were compared (p>0.05). A significant difference was found between the SVV values of the control group and the SVV values of the patient group before the treatment (p<0.05). A significant difference was found between the SVV values of the control group and the SVV values of the patient group after the maneuver (p<0.05). A significant difference was found between the DSVV values of the control group and the DSVV values before the treatment (p<0.05), but no significant difference was found between the DSVV values after the treatment (p>0.05). A significant difference was found between pre-manoeuvre P1 latency values and P1 – N1 amplitude values and normative data obtained from pationt individuals (p<0.05). A significant difference was found between P1 latency values and P1 – N1 amplitude values after maneuver obtained from sick individuals and normative data (p<0.05). There is a positive correlation between the SVV – DSVV values obtained before and after the treatment in pationt individuals (p<0.05). There was a negative correlation between the SVV values obtained before the treatment and the left ear P1 – N1 amplitude values obtained after the treatment in patient individuals (p<0.05). Conclusion: Our research demonstrates that BPVV affects vertical perception and that utricular functions are similarly compromised in BPPV patients. As a result of the tests performed following the treatment maneuvers, there was no significant effect of recovery on the SVV test value; It was found to have a positive effect on DSVV test values. For future research, it might be beneficial to obtain more samples.