Seven-year Study Highlights Long-term Risks Even After Successful Bppv Treatment

A new long-term study published in Otolaryngology–Head and Neck Surgery, the official peer-reviewed journal of the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF), suggests that benign paroxysmal positional vertigo (BPPV) may continue to affect patients years after successful initial treatment.

The seven-year study followed 361 patients treated for BPPV and found that nearly half (47.1%) experienced at least one recurrence. In addition, 37.6% reported persistent residual dizziness, while 18.9% experienced a fall during the follow-up period.

BPPV, the most common cause of vertigo, occurs when calcium carbonate crystals (otoconia) become displaced within the inner ear. The condition is typically treated using canal repositioning maneuvers, which are generally considered highly effective in resolving acute symptoms.

However, researchers at Getafe University Hospital in Madrid, Spain, found that long-term consequences may persist for a substantial number of patients, highlighting the need for ongoing monitoring, patient education, and fall-risk awareness.

The findings align with recommendations outlined in the updated AAO-HNSF Clinical Practice Guideline (CPG) for BPPV, which emphasizes canal-specific repositioning maneuvers as first-line treatment while also addressing vestibular rehabilitation, patient education, and follow-up care for patients with unresolved symptoms.

The study also connects with a broader national initiative led by the AAO-HNSF focused on age-friendly care in otolaryngology. Supported through a grant from the Council of Medical Specialty Societies and The John A. Hartford Foundation, the initiative aims to integrate age-friendly principles into otolaryngology practices across the United States, with fall prevention identified as a major focus area.

“Otolaryngologists are on the front lines of addressing some of the most significant health challenges facing older adults, from hearing loss and its connection to cognitive decline to vestibular dysfunction and fall risk. The CMSS grant allows us to equip our members with specialty-specific, evidence-based tools that continue to put patients at the center of their care—empowering older adults to have more meaningful conversations with their doctors about what matters most to them.”

–Rahul K. Shah, MD, MBA, AAO-HNSF Executive Vice President and CEO

According to the AAO-HNSF, BPPV prevalence is nearly seven times higher in adults over the age of 60, making vestibular disorders an increasingly important consideration in age-friendly healthcare.

Reference

• Martin-Sanz, E., Chaure-Cordero, M., Fernández-Navarro, C., Solis-Fesser, A., & Riestra-Ayora, J. (2026). Long-term benign paroxysmal positional vertigo: Recurrence, residual symptoms and risk of falls. Otolaryngology–Head and Neck Surgery. https://doi.org/10.1002/ohn.70257

About Otolaryngology–Head and Neck Surgery

Otolaryngology–Head and Neck Surgery (OTO Journal) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. Its mission is to publish contemporary, ethical, and clinically relevant information in otolaryngology and head and neck surgery that can be used by clinicians, scientists, and specialists to improve patient care and public health.

About the AAO-HNS/F

The AAO-HNS/F is one of the world’s largest organizations representing specialists who treat the ears, nose, throat, and related structures of the head and neck. Otolaryngologist-head and neck surgeons diagnose and treat medical disorders that are among the most common affecting patients of all ages in the United States and around the world.

These conditions include chronic ear disease, hearing and balance disorders, hearing loss, sinusitis, snoring and sleep apnea, allergies, swallowing disorders, nosebleeds, hoarseness, dizziness, and tumors of the head and neck, as well as aesthetic and reconstructive surgery and intricate microsurgical procedures of the head and neck.

The Academy has approximately 13,000 members. The AAO-HNS Foundation works to advance the art, science, and ethical practice of otolaryngology-head and neck surgery through education, research, and quality measurement.

Source: AAO-HNS/F, OTO Journal

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