Benign paroxysmal positional vertigo (BPPV) frequently recurs after successful canalith repositioning maneuvers (CRMs). Vitamin D deficiency has been linked to recurrence, but whether adding vitamin K₂ to vitamin D₃ provides additional benefit remains uncertain. We compared 12-month BPPV recurrence among patients receiving combined vitamin D₃ and K₂ (D3K2), vitamin D₃ alone (D3), or CRM alone, and examined whether the association differed by BPPV subtype.
This prospective, nonrandomized cohort study included 404 adults successfully treated with a CRM at a single otolar-yngology center in Amman, Jordan. Treatment was not randomly allocated; participants formed a convenience sample and received D3K2 (n = 212), D3 alone (n = 105), or CRM alone (n = 87). Recurrence was clinically confirmed during 12 months of follow-up. Modified Poisson regression with robust variance estimated risk ratios (RRs), adjusting for age, sex, and BPPV subtype.
