Objective  To systematically evaluate the recurrence rate and related influencing factors in patients with benign paroxy-smal positional vertigo (BPPV) after otolith repositioning.

Methods  PubMed, Web of Science, The Cochrane Library, Embase, CINAHL, CNKI, VIP, WanFang and SinoMed were sysmatically searched from the inception to July 18, 2025 for studies on the recurrence rate and related influencing factors in patients with BPPV after otolith repositioning, and Meta-analysis was performed on the included literature using Stata 16.0 and RevMan 5.4 software.

Results  A total of 21 papers involving 6,566 patients were finally included. The results showed that the recurrence rate after otolith repositioning in patients with BPPV was 0.27 [95%CI (0.26, 0.28)], sleep disorders [OR=2.04, 95%CI (1.06, 3.92)], age [OR=1.80,95%CI (1.06, 3.05)], and 25-hydroxyvitamin D levels [OR=3.18, 95%CI (2.07, 4.87)], anxiety and depression [OR=2.61, 95%CI (1.13, 6.06)], long-term computer use [OR=3.09, 95%CI (1.66, 5.75)], overexertion [OR=3.47, 95%CI (1.75, 6.89)], diabetes mellitus [OR=2.73, 95%CI (2.15, 3.46)], hyperlipidemia [OR=1.59, 95%CI (1.34, 1.89)], number of repositioning attempts [OR=2.06, 95%CI (1.36, 3.13)], duration of illness [OR=1.70, 95%CI (1.38, 2.09)], hypertension [OR=3.35, 95%CI (2.25, 5.01)], history of head trauma [OR=3.29, 95%CI (2.13, 5.06)], migraine [OR=5.18, 95%CI (1.31, 20.46)], and concomitant Meniere's disease [OR=4.81, 95%CI (2.46, 9.38)] were the influencing factors in recurrence after otolith repositioning in patients with BPPV.

Conclusion  The high rate of recurrence after otolith repositioning in BPPV patients is mainly influenced by patients' physiological, psychological, lifestyle and disease-related factors, and clinical healthcare professionals can develop interventions in combination with the above influencing factors, to reduce the risk of disease recurrence after repositioning in BPPV patients.

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