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. 2021 Oct;41(5):401-409.
doi: 10.14639/0392-100X-N1543.

Vascular mechanisms in acute unilateral peripheral vestibulopathy: a systematic review

João Simões  1   2 , Stephan Vlaminck  1 , Raquel Seiça  2 , Frederic Acke  3 , António Miguéis  4
Affiliations

Vascular mechanisms in acute unilateral peripheral vestibulopathy: a systematic review

João Simões et al. Acta Otorhinolaryngol Ital. 2021 Oct.

Abstract

Meccanismi vascolari nella vestibolopatia periferica acuta unilaterale: una revisione sistematica.

Riassunto: La vestibolopatia periferica unilaterale acuta (AUPVP) è causa frequente di perdita della funzione vestibolare. Sono state proposte diverse eziologie, ma il meccanismo esatto rimane sconosciuto. Lo scopo di questo studio è condurre un’analisi sistematica della letteratura per valutare l’eziologia vascolare dell’AUPVP. Una ricerca sistematica della letteratura è stata eseguita mediante PubMed, Cochrane Library ed Embase, includendo articoli pubblicati dal 1 gennaio 2010 al 30 novembre 2020. Due revisori hanno selezionato in modo indipendente articoli che studiano un collegamento tra AUPVP e malattie vascolari. Sono state estratte le seguenti informazioni: anno di pubblicazione, paese, livello di evidenza, fattori di rischio vascolare valutati e numero di pazienti. In totale sono stati identificati 450 articoli. Tra questi sono stati considerati gli undici su cui vi era completo accordo fra i due revisori. In una popolazione aggregata di 805 pazienti, i risultati principali sono stati il più alto rapporto tra neutrofili e linfociti e la maggiore prevalenza di fattori di rischio vascolare tra i pazienti con AUPVP. Non è stata eseguita una meta-analisi perché gli studi erano troppo eterogenei per quanto riguarda la metodologia. Sono stati trovati argomenti indiretti per i meccanismi vascolari in AUPVP. Questi risultati indicano che sono necessari studi prospettici più ampi e ben controllati per chiarire l’eziologia vascolare in AUPVP.

Keywords: acute unilateral vestibulopathy; acute vertigo; risk factors; vascular; vestibular neuritis.

Plain language summary

Acute unilateral peripheral vestibulopathy (AUPVP) is a frequent cause of vestibular loss. Several aetiologies have been proposed, but the exact mechanism remains unknown. The aim of this study is a systematic analysis of the literature evaluating the vascular aetiology of AUPVP. A systematic literature search was performed in PubMed, Cochrane Library and Embase, including articles published from January 1st, 2010 to November 30th, 2020. Two reviewers independently selected articles investigating a link between AUPVP and vascular disease. The following information was extracted: year of publication, country, level of evidence, assessed vascular risk factors and number of patients. A total of 450 articles was obtained. Eleven articles were retained with 100% agreement between the two reviewers. In a pooled population of 805 patients, the main results were the higher neutrophil to lymphocyte ratio and higher prevalence of vascular risk factors among AUPVP patients. A meta-analysis was not performed because the studies were too heterogeneous in terms of methodology. Indirect arguments for vascular mechanisms in AUPVP were found. These findings indicate that larger prospective well-controlled studies are needed to clarify the vascular aetiology of AUPVP.

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Conflict of interest statement

Conflict of interest

The Authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
PRISMA flow diagram.
See this image and copyright information in PMC

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