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ORL 2010;72:63–67

Frequency of Sinus Disease in Normal Subjects and Patients with Benign Paroxysmal Positional Vertigo

Cohen H.S. · Stewart M.G. · Brissett A.E. · Olson K.L. · Takashima M. · Sangi-Haghpeykar H.
Bobby R. Alford Department of Otolaryngology – Head and Neck Surgery, Baylor College of Medicine, Houston, Tex., USA
email Corresponding Author

 goto top of outline Key Words

  • Benign paroxysmal positional vertigo
  • Public health
  • Rhinosinusitis
  • Sinus disease

 goto top of outline Abstract

Background/Aims: To determine if patients with benign paroxysmal positional vertigo (BPPV) have a higher frequency of rhinosinusitis than people with normal vestibular function. Methods: The subjects were 52 patients with BPPV and 46 normal people. Every subject had a sinus CT scan, a blood draw for IgE and a rhinologic examination by an otolaryngologist. Results: The frequency of rhinosinusitis based on physician diagnosis was 49% and based on CT scan findings 59%. This difference approached significance (p = 0.08). The observed frequency of rhinosinusitis was higher than predicted by survey data about the southern US region. The data trended toward higher prevalence of rhinosinusitis (by physician diagnosis) in the BPPV patients versus controls (58 vs. 39%, p = 0.06). Conclusion: BPPV patients have a higher frequency of sinus disease compared to people with normal vestibular systems, perhaps due to age differences, but physiologic factors may also be involved. The higher frequency of rhinosinusitis in this geographical area than reported rates based on survey data raises concerns about the usefulness of questionnaire data for estimating population prevalence.

Copyright © 2010 S. Karger AG, Basel

 goto top of outline References
  1. Coats AC: Vestibular neuronitis. Acta Otolaryngol Suppl 1969;251:1–32.
  2. Dix MR, Hallpike CS: The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Proc R Soc Med 1952;45:341–354.
  3. Haid T: Vertigo originating from inflammation of the paranasal sinuses (the so-called sinugenic vertigo). Adv Otorhinolaryngol 1981;27:190–197.
  4. Cohen H, Kimball KT, Stewart MG: Benign paroxysmal positional vertigo and co-morbid conditions. ORL 2004;66:11–15.

    External Resources

  5. Summary Health Statistics for US Adults: National Health Interview Survey, 2008, provisional report. Vital and Health Statistics Series 10, No 242. Hyattsville, National Center for Health Statistics, Centers for Disease Control and Prevention, US Department of Health and Human Services, 2009.
  6. Martin TJ, Yauck JS, Smith T: Patients undergoing sinus surgery: constructing a demographic profile. Laryngoscope 2006;116:1185–1191.
  7. Rosenfeld RM, Andes D, Bhattacharyya N, Cheung D, Eisengerg S, Ganiats TG, et al: Clinical practice guideline: adult sinusitis. Otolaryngol Head Neck Surg 2007;137:S1–S31.
  8. Gliklich RE, Metson R: A comparison of sinus computed tomography (CT) staging systems for outcomes research. Am J Rhinol 1994;8:291–297.

    External Resources

  9. Meltzer EO, Hamilos DL, Hadley JA, Lanza DC, Marple BF, Nicklas RA, et al: Rhinosinusitis: developing guidance for clinical trials. Otolaryngol Head Neck Surg 2006;135:S31–S80.
  10. Flinn J, Chapman ME, Wightman AJA, Maran AGD: A prospective analysis of incidental paranasal sinus abnormalities on CT head scans. Clin Otolaryngol 1994;19:287–289.
  11. Havas TE, Motbey JA, Gullane PJ: Prevalence of incidental abnormalities on computerised tomographic scans of the paranasal sinuses. Otolaryngol Head Neck Surg 1988;114:865–859.
  12. Lloyd GA: CT of the paranasal sinuses: study of a control series in relation to endoscopic sinus surgery. J Laryngol Otol 1990;104:477–481.
  13. Engel PJH: Tacit kowledge and visual expertise in medical diagnostic reasoning: implications for medical education. Med Teach 2008;30:e184–e188.

    External Resources

  14. Goldman GM: The tacit dimension of clinical judgment. Yale J Biol Med 1990;63:47–61.
  15. Polanyi M: The Tacit Dimension. Gloucester, Doubleday & Co, 1966.
  16. Smith WM, Davidson TM, Murphy C: Regional variations in chronic rhinosinusitis, 2003–2006. Otolaryngol Head Neck Surg 2009;141:347–352.
  17. Busaba NY, Sin HJ, Salman SD: Impact of gender on clinical presentation of chronic rhinosinusitis with and without polyposis. J Laryngol Otol 2008;122:1180–1184.

 goto top of outline Author Contacts

Helen S. Cohen
Department of Otolaryngology
Baylor College of Medicine, One Baylor Plaza
Houston, TX 77030 (USA)
Tel. +1 713 798 6336, Fax +1 713 798 8658, E-Mail

 goto top of outline Article Information

Received: December 12, 2009
Accepted: February 21, 2010
Published online: April 24, 2010
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 2, Number of References : 17

 goto top of outline Publication Details

ORL (Journal for Oto-Rhino-Laryngology, Head and Neck Surgery)

Vol. 72, No. 1, Year 2010 (Cover Date: May 2010)

Journal Editor: O'Malley Jr. B.W. (Philadelphia, Pa.)
ISSN: 0301-1569 (Print), eISSN: 1423-0275 (Online)

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