{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T23:47:44Z","timestamp":1785196064079,"version":"3.55.0"},"reference-count":23,"publisher":"Index Copernicus","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Otolaryngol Pol"],"published-print":{"date-parts":[[2025,5,29]]},"abstract":"<ns3:p>&lt;b&gt;Introduction:&lt;\/b&gt; Vitamin D is crucial for calcium metabolism, and its role in benign paroxysmal positional vertigo (BPPV) pathogenesis has been increasingly recognized. However, its impact on treatment resistance in BPPV patients remains unclear and understudied.&lt;b&gt;Aim:&lt;\/b&gt; This study investigated the association between treatment resistance in BPPV and various risk factors, including vitamin D deficiency, age, gender, and comorbidities.&lt;b&gt;Materials and methods:&lt;\/b&gt; A retrospective review of medical records was conductedon 122 patients diagnosed with BPPV at a tertiary care hospital between January2020 and January 2023. The diagnosis of BPPV was confirmed using clinical historyand positional tests, while serum 25-OH vitamin D levels were measured usingchemiluminescence immunoassay. Patients who required three or more canalithrepositioning maneuvers were considered treatment-resistant. Logistic regressionanalysis was employed to assess the impact of demographic and clinical factors onBPPV treatment resistance, and recurrence rates were evaluated over a one-yearfollow-up period.&lt;b&gt;Results:&lt;\/b&gt; Logistic regression revealed that male gender, comorbidities, and betahistine use were significantly associated with BPPV resistance (p &lt; 0.05), while no significant relationship was found between vitamin D levels and treatment resistance or recurrence (p &gt; 0.05). Recurrence was observed in 22.1% of patients during the follow- -up period, though this was not significantly related to vitamin D status.&lt;b&gt;Conclusions:&lt;\/b&gt; While previous studies suggested a potential link between vitamin Ddeficiency and BPPV recurrence, this study found no significant association betweenvitamin D deficiency and resistance along with the recurrence of BPPV. Instead, malegender, comorbidities (notably hypertension), and betahistine use were identified asrisk factors for requiring multiple maneuvers. The study raises questions about therole of vitamin D in BPPV pathophysiology and suggests that other clinical factorsmay have a greater influence on treatment outcomes.<\/ns3:p>","DOI":"10.5604\/01.3001.0055.0939","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T06:51:33Z","timestamp":1748501493000},"page":"1-7","source":"Crossref","is-referenced-by-count":3,"title":["Is Vitamin D Deficiency a Cause of Refractory Benign Paroxysmal Positional Vertigo (BPPV)?"],"prefix":"10.5604","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0698-2709","authenticated-orcid":false,"given":"Dastan","family":"Temirbekov","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Medicine, Istanbul Aydin University, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4618-6341","authenticated-orcid":false,"given":"Elif","family":"Sari","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Medicine, Istanbul Aydin University, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3689","reference":[{"key":"629015r1","doi-asserted-by":"crossref","unstructured":"Sayin I., Ko\u00e7 R.H., Temirbekov D. et al.: Betahistine add-on therapy for treatment ofsubjects with posterior benign paroxysmal positional vertigo: a randomized controlledtrial. Braz J Otorhinolaryngol., 2022; 88(3): 421\u2013426. doi: 10.1016\/j.bjorl.2020.07.011.","DOI":"10.1016\/j.bjorl.2020.07.011"},{"key":"629015r2","doi-asserted-by":"crossref","unstructured":"Chen J., Zhang S., Cui K., Liu C.: Risk factors for benign paroxysmal positionalvertigo recurrence: a systematic review and meta-analysis. J Neurol., 2021;268(11): 4117\u20134127. doi: 10.1007\/s00415-020-10175-0.","DOI":"10.1007\/s00415-020-10175-0"},{"key":"629015r3","doi-asserted-by":"crossref","unstructured":"Sfakianaki I., Binos P., Karkos P., Dimas G.G., Psillas G.: Risk Factors for Recurrenceof Benign Paroxysmal Positional Vertigo. A Clinical Review. J ClinMed., 2021; 10(19): 4372. doi: 10.3390\/jcm10194372.","DOI":"10.3390\/jcm10194372"},{"key":"629015r4","doi-asserted-by":"crossref","unstructured":"Holick M.F.: The vitamin D deficiency pandemic: Approaches for diagnosis,treatment and prevention. Rev Endocr Metab Disord., 2017; 18(2): 153\u2013165.doi: 10.1007\/s11154-017-9424-1.","DOI":"10.1007\/s11154-017-9424-1"},{"key":"629015r5","doi-asserted-by":"crossref","unstructured":"Holick M.F.: Vitamin D deficiency. N Engl J Med., 2007; 357(3): 266\u2013281. doi:10.1056\/NEJMra070553.","DOI":"10.1056\/NEJMra070553"},{"key":"629015r6","doi-asserted-by":"crossref","unstructured":"Institute of Medicine (US) Committee to Review Dietary Reference Intakes forVitamin D and Calcium. Dietary Reference Intakes for Calcium and VitaminD. Eds.: Ross A.C., Taylor C.L., Yaktine A.L., Del Valle H.B. National AcademiesPress (US), Washington (DC) 2011. doi: 10.17226\/13050.","DOI":"10.17226\/13050"},{"key":"629015r7","doi-asserted-by":"crossref","unstructured":"Eyles D.W., Smith S., Kinobe R., Hewison M., McGrath J.J.: Distribution of thevitamin D receptor and 1 alpha-hydroxylase in human brain. J Chem Neuroanat.,2005; 29(1): 21\u201330. doi: 10.1016\/j.jchemneu.2004.08.006.","DOI":"10.1016\/j.jchemneu.2004.08.006"},{"key":"629015r8","doi-asserted-by":"crossref","unstructured":"Sarsitthithum K., Wisupagan T., Kiatthanabumrung S., Jariengprasert C.: The AssociationBetween Serum Vitamin D Levels and Benign Paroxysmal Positional Vertigo.Ear Nose Throat J., 2023; 102(7): 473\u2013477. doi: 10.1177\/01455613211008561.","DOI":"10.1177\/01455613211008561"},{"key":"629015r9","doi-asserted-by":"crossref","unstructured":"Elmoursy M.M., Abbas A.S.: The role of low levels of vitamin D as a co-factorin the relapse of benign paroxysmal positional vertigo (BPPV). Am J Otolaryngol.,2021; 42(6): 103134. doi: 10.1016\/j.amjoto.2021.103134.","DOI":"10.1016\/j.amjoto.2021.103134"},{"key":"629015r10","doi-asserted-by":"crossref","unstructured":"Rhim G.I.: Serum Vitamin D and Long-term Outcomes of Benign ParoxysmalPositional Vertigo. Clin Exp Otorhinolaryngol, 219; 12(3): 273\u2013278. doi:10.21053\/ceo.2018.00381.","DOI":"10.21053\/ceo.2018.00381"},{"key":"629015r11","unstructured":"Sheikhzadeh M., Lotfi Y., Mousavi A. et al.: Influence of supplemental vitaminD on intensity of benign paroxysmal positional vertigo: A longitudinal clinicalstudy. Caspian J Intern Med., 2016; 7(2): 93\u201398."},{"key":"629015r12","unstructured":"Reha A.: Uygulamal\u0131 \u00e7ok de\u011fi\u015fkenli istatistiksel y\u00f6ntemler. 4th ed., DetayYay\u0131nc\u0131l\u0131k, T\u00fcrkiye 2013."},{"key":"629015r13","doi-asserted-by":"crossref","unstructured":"Hilton M.P., Pinder D.K.: The Epley (canalith repositioning) manoeuvre forbenign paroxysmal positional vertigo. Cochrane Database Syst Rev., 2014;2014(12): CD003162. doi: 10.1002\/14651858.CD003162.pub3.","DOI":"10.1002\/14651858.CD003162.pub3"},{"key":"629015r14","doi-asserted-by":"crossref","unstructured":"Power L., Murray K., Szmulewicz D.J.: Characteristics of assessment and treatmentin Benign Paroxysmal Positional Vertigo (BPPV). J Vestib Res., 2020;30(1): 55\u201362. doi: 10.3233\/VES-190687.","DOI":"10.3233\/VES-190687"},{"key":"629015r15","doi-asserted-by":"crossref","unstructured":"Lundberg Y.W., Zhao X., Yamoah E.N.: Assembly of the otoconia complex tothe macular sensory epithelium of the vestibule. Brain Res., 2006; 1091(1):47\u201357. doi: 10.1016\/j.brainres.2006.02.083.","DOI":"10.1016\/j.brainres.2006.02.083"},{"key":"629015r16","doi-asserted-by":"crossref","unstructured":"Talaat H.S., Abuhadied G., Talaat A.S., Abdelaal M.S.: Low bone mineral densityand vitamin D deficiency in patients with benign positional paroxysmalvertigo. Eur Arch Otorhinolaryngol., 2015; 272(9): 2249\u20132253. doi: 10.1007\/s00405-014-3175-3.","DOI":"10.1007\/s00405-014-3175-3"},{"key":"629015r17","doi-asserted-by":"crossref","unstructured":"Rhim G.I.: Serum vitamin D and recurrent benign paroxysmal positionalvertigo. Laryngoscope Investig Otolaryngol., 2016; 1(6): 150\u2013153. doi:10.1002\/lio2.35.","DOI":"10.1002\/lio2.35"},{"key":"629015r18","doi-asserted-by":"crossref","unstructured":"Vibert D., Sans A., Kompis M. Et al.: Ultrastructural changes in otoconiaof osteoporotic rats. Audiol Neurootol., 2008; 13(5): 293\u2013301. doi:10.1159\/000124277.","DOI":"10.1159\/000124277"},{"key":"629015r19","doi-asserted-by":"crossref","unstructured":"Goldschagg N., Teupser D., Feil K., Strupp M.: No evidence for a specific vitaminD deficit in benign paroxysmal positional vertigo. Eur J Neurol., 2021;28(9): 3182\u20133186. doi: 10.1111\/ene.14980.","DOI":"10.1111\/ene.14980"},{"key":"629015r20","doi-asserted-by":"crossref","unstructured":"Korkmaz M., Korkmaz H.: Cases requiring increased number of repositioningmaneuvers in benign paroxysmal positional vertigo. Braz J Ootorhinolaryngol.,2016; 82(4): 452\u2013457. doi: 10.1016\/j.bjorl.2015.08.018.","DOI":"10.1016\/j.bjorl.2015.08.018"},{"key":"629015r21","doi-asserted-by":"crossref","unstructured":"Bhattacharyya N., Gubbels S.P., Schwartz S.R. et al.: Clinical Practice Guideline:Benign Paroxysmal Positional Vertigo (Update). Otolaryngol Head NeckSurg., 2017; 156(3_suppl): S1\u2013S47. doi: 10.1177\/0194599816689667.","DOI":"10.1177\/0194599816689667"},{"key":"629015r22","doi-asserted-by":"crossref","unstructured":"Sreenivas V., Sima N.H., Philip S.: The Role of Comorbidities in Benign ParoxysmalPositional Vertigo. Ear Nose Troat J., 2021; 100(5): NP225\u2013NP230.doi: 10.1177\/0145561319878546.","DOI":"10.1177\/0145561319878546"},{"key":"629015r23","doi-asserted-by":"crossref","unstructured":"Hanel A., Carlberg C.: Vitamin D and evolution: Pharmacologic implications.Biochem Pharmacol., 2020; 173: 113595. doi: 10.1016\/j.bcp.2019.07.024.","DOI":"10.1016\/j.bcp.2019.07.024"}],"container-title":["Otolaryngologia Polska"],"original-title":[],"link":[{"URL":"https:\/\/otolaryngologypl.com\/gicid\/pdf\/01.3001.0055.0939","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/otolaryngologypl.com\/gicid\/pdf\/01.3001.0055.0939","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T06:51:40Z","timestamp":1748501500000},"score":1,"resource":{"primary":{"URL":"https:\/\/otolaryngologypl.com\/gicid\/01.3001.0055.0939"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,29]]},"references-count":23,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,5,29]]}},"URL":"https:\/\/doi.org\/10.5604\/01.3001.0055.0939","relation":{},"ISSN":["0030-6657","2300-8423"],"issn-type":[{"value":"0030-6657","type":"print"},{"value":"2300-8423","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,29]]}}}