Identifying key risk factors for the recurrence of benign paroxysmal positional vertigo following successful canalith repositioning maneuvers: a meta analysis.

Background: An increasing occurrence trend of benign paroxysmal positional vertigo (BPPV) after successful canalith repositioning maneuvers was observed; however, the risk elements for the occurrence of this disease remain undefined. We aimed to conduct a meta-analysis of BPPV occurrence-associated risk factors reported.

Methods: A comprehensive search in MEDLINE, EMBASE, PubMed, Springer, and the Cochrane Library up to March 31, 2024. The meta-analysis was carried out with STATA 16.0. Quality evaluation of the articles was performed with the Newcastle-Ottawa Scales (NOS). Data were pooled by a random-effects model. The meta-analysis was registered at INPLASY (202430045).

Results: Seventeen studies with 229 patients were included in the present analysis. The recurrence rate of BPPV after Canalith repositioning procedure (CRP) or Epley maneuver in subjects with hypertension [standardized mean difference (SMD) = 0.88,95% confidence interval (CI) (0.81-0.96), P = 0.00], Meniere's disease [SMD = 0.84, 95%CI (0.57-1.10), P = 0.00], head trauma [SMD = 0.48, 95%CI (0.34-0.63), P = 0.00], diabetes mellitus (DM) [SMD = 0.87, 95%CI (0.80-0.94), P = 0.00], advanced age [SMD = 0.18, 95%CI (0.08-0.28), P = 0.00], osteoporosis [SMD = 0.32, 95%CI (0.20-0.43), P = 0.00], female gender [SMD = 0.53, 95%CI (0.40-0.67), P = 0.00], migraine headache [SMD = 0.20, 95%CI (0.06-0.35), P = 0.01], and vitamin D deficiency [OR = 0.29, 95%CI (0.18-0.40), P = 0.00] were appreciably higher than those in patients without hypertension, Meniere's disease, head trauma, DM, advanced age, osteoporosis, female gender, migraine headache, and vitamin D deficiency.

Conclusions: This meta-analysis has identified several significant risk factors associated with the recurrence of BPPV following successful canalith repositioning procedures. These include Meniere's disease, head trauma, diabetes mellitus, migraine headaches, female gender, advanced age, osteoporosis, and vitamin D deficiency.