Association Between Benign Paroxysmal Positional Vertigo and Vitamin D Deficiency ; Sohag University Hospital Experience.

Introduction Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder, accounting for approximately 20-30% of vertigo cases in clinical practice. It is characterized by brief episodes of vertigo triggered by changes in head position, often due to dislodged otoconia in the semicircular canals. While canalith repositioning maneuvers like the Epley maneuver are highly effective for treatment, BPPV has a notable recurrence rate of 30-50% within the first year. The etiology remains largely idiopathic, but emerging evidence suggests a potential link to metabolic factors, particularly vitamin D deficiency.

Vitamin D plays a crucial role in calcium homeostasis and bone metabolism, which extends to the inner ear's otolithic apparatus, where calcium carbonate crystals (otoconia) are essential for vestibular function. Deficiency in vitamin D may impair otoconia maintenance, increasing susceptibility to dislodgement and thus BPPV onset or recurrence. Globally, vitamin D deficiency affects up to 1 billion people, with higher prevalence in regions like the Middle East due to limited sun exposure, dietary habits, and cultural factors such as veiling.54cc4a In Egypt, studies report deficiency rates exceeding 70% in the general population, exacerbated by urban lifestyles and pollution in areas like Sohag.

At Sohag University Hospital, a tertiary care center serving a large rural-urban population in Upper Egypt, BPPV constitutes a significant portion of otolaryngology consultations. Preliminary local data indicate a high BPPV incidence among young adults and the elderly, yet the role of vitamin D has not been systematically explored in this setting. This study addresses this gap by examining the association between serum vitamin D levels and BPPV, potentially informing preventive strategies like supplementation in high-risk groups.

Aim of the Work The primary aim is to investigate the association between serum 25-hydroxyvitamin D (25-OH D) levels and the presence of BPPV in patients attending the Otolaryngology Department and Audiovestibular unit at Sohag University Hospital. Secondary aims include identifying potential confounders (e.g., age, sex, comorbidities).

Patients and Methods Study Design: This is a hospital-based case-control study. Setting: Otolaryngology (ENT) Outpatient Clinic and Audiovestibular unit at Sohag University Hospital, Sohag, Egypt.