No5(5) 2022
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DOI 10.37219/2528-8253-2022-5-29 |
Shevchenko TA, Belyakova IA, Hradiuk NM
Risk factors of vestibular disorders in patients with metabolic disorders in
the bone |
Shevchenko Tetiana Oleksandrivna
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine.
Ear Microsurgery and Otoneurosurgery Department
Junior Researcher
Candidate of Medical Sciences
E-mail: nuha1977@ukr.net
Orchid ID: https://orcid.org/0000-0002-4338-3202
Belyakova Irina A.
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine
Laboratory of Clinical Audiology and Vestibulology
Leading researcher
PhD
E-mail: amtc@kndio.kiev.ua
Hradiuk Nataliya
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of
National Academy of Medical Science of Ukraine”; Kyiv, Ukraine
Laboratory of Clinical Audiology and Vestibulology
Junior Researcher
E-mail: svr_lor@ukr.net
ORCID ID: 0000-0003-1298-6420 |
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Abstract
Actuality: Vestibular disorders of central and peripheral origin are
often observed in patients with impaired bone mineral metabolism. Despite
the benign nature, they cause significant disturbances in social life.
Aim: study clinical and laboratory parameters and vestibular
disorders in patients with different forms of benign paroxysmal positional
vertigo (BPPV), related to degenerative-dystrophic changes of the
musculoskeletal system and identify ways to further correct them.
Materials and methods: We have studied 60 patients with BPPV. All
patients underwent bone densitometry, examined the loss of bone strength of
the spine and hip joint, vestibulometric study. Determined the value of
mineral metabolism: the content of calcium and vitamin D in serum. To verify
BPPV and its type, patients underwent posit ional tests.
Results and discussions: 60 patients who complained of dizziness, on
the basis of additional examination was diagnosed with BPPVs.
Otitolithithiasis of the posterior semicircular canal was diagnosed in 44
patients, horizontal canal – in 8 patients, cupulo-lithiasis – in 10
patients. Depending on the condition of the vestibular systeme, patients
were divided into 2 groups. Group 1 included 24 patients with peripheral
vestibular disorders, group 2 included 36 patients with mixed vestibular
dysfunction. According to the results of absorption densitometry in
patients, mineral metabolism disorders were detected: osteopenia in 41
patients, the average T-test was (-1.9±0.3) SD, osteoporosis – In 19
patients, T-test was (-2.8 ± 0.2) SD. Serum calcium and vitamin D deficiency
have been noted in patients with BPPV, indicating impaired mineral
metabolism. In order to correct mineral metabolism and antirelapse therapy,
patients with BPPV were prescribed vestibuloplegics, calcium, vitamin D for
12
months.
Conclusions: studies have found a correlation between BPPV and bone
mineral metabolic disorders. It indicated the presence of osteopenia and
osteoporosis in patients with DPPD, as well as changes in the levels of
mineral metabolism of bone (in addition to calcium and vitamin D in serrum).
Such changes in mineral metabolism may be a biomarker of otolithic
degeneration, maintain a causal relationship between lower serum vitamin D
and calcium levels and the development of BPPV, and cause frequent attacks. |
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Keywords
benign paroxysmal positional vertigo, dizziness, otolitholithiasis,
cupololithiasis, osteoporosis, bone metabolic disorders. |
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