Benign Paroxysmal Positional Vertigo in Oral Surgery and Implantology: A Review.

Abstract

Benign paroxysmal positional vertigo (BPPV) is a common inner ear disorder characterized by intense dizziness often triggered by sudden head movements. Certain dental and maxillofacial surgeries may induce BPPV due to vibrational trauma from instrumentation, extended hyperflexion of the head, and existing vestibular conditions. This study aimed to analyze certain oral and maxillofacial surgical procedures associated with BPPV and evaluate prevention and treatment strategies. A review of relevant literature was conducted through Google Scholar and an extensive search on PubMed for the period 2005-2020 using the keywords "BPPV" and "benign paroxysmal positional vertigo." Articles were screened up to the 2564th listing, focusing on cases of postsurgical BPPV. Eight studies were included and analyzed, including case reports, retrospective analyses, and literature reviews. The procedures that led to BPPV in these studies include sinus floor elevation, maxillary implant placement, third molar extractions, and orthognathic surgery. Factors that contributed to the development of BPPV include surgical trauma, use of osteotomes, abnormal head positioning, and preexisting vestibular conditions. Although postoperative BPPV is typically self-limiting, treatment may involve physical rehabilitation (Epley maneuver) or pharmacotherapy (benzodiazepines, antihistamines). Analysis of the studies revealed that treatment considerations may include referral to an ear, nose, and throat practitioner for management; careful review of the patient's medical history; proper patient positioning; and cautious use of osteotomes. Although BPPV is a rare complication, surgeons should be aware of its potential implications to mitigate unnecessary development of BPPV and management of the condition. Further research is needed on the optimal prevention, treatment, and patient management strategies.