BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV) FOLLOWING MAXILLOFACIAL PROCEDURES AND TRAUMA: A RARE BUT REAL COMPLICATION-REVIEW AND CASE REPORT

The most common type of peripheral vertigo, benign paroxysmal positional vertigo (BPPV), is caused by dislodging otoconia (calcium carbonate crystals) into the inner ear's semicircular canals, which lead to transient episodes of vertigo with positional head movements. Otolaryngology and neurology clinics regularly experience BPPV, but oral and maxillofacial surgery are increasingly diagnosing it, particularly after percussive instruments, vibrational forces, or major cranial manipulations [1][2]. Indirect sinus lifts with osteotomes and surgical mallets have been associated with BPPV [3][4]. New evidence, though, links ridge augmentation, TMJ surgery, Densah bur mandibular implant placements, and facial trauma reconstruction with BPPV [5][6][7]. Osteotomy mechanical stress, over-tapping, and neck hyperextension may induce BPPV through the vibration of the vestibular system [8][9]. BPPV mechanical mechanism, clinical diagnosis, and oral and maxillofacial treatment are discussed in this comprehensive study. Two case reports consist of a peculiar BPPV case after flapless mandibular implant placement with the use of osseodensification burs, a low-trauma procedure. Early identification, appropriate diagnosis, interdisciplinary referral, and surgical prevention are emphasized. Awareness can be beneficial in enhancing maxillofacial surgical patient safety, medico-legal risks, and recovery [10][11][12].