Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2026 02 23 1533 1533 Mohammad Akbar Fayaz - Mansoureh Adel Ghahraman Elham Tavanai - Kazem Malmir - Nasrin Yazdani - Akram Farahani - Mohammad Amin Safari - 2025 12 31 2026 02 18 Background and Aim: Inflammatory processes play a key role in vestibular neuritis (VN) pathogenesis, and recent research has associated vitamin D deficiency with various audio-vestibular conditions, including reduced serum 25-hydroxyvitamin D [25(OH)D] concentrations in individuals with acute VN. Given its notable immunomodulatory and anti-inflammatory actions, vitamin D may serve as an adjunct to enhance VRT outcomes. The present study examined the impact of combining 25(OH)D supplementation with VRT on vestibular function among patients with VN. Methods: In this randomized controlled trial, 41 patients with VN were allocated into two groups. The VRT group (n=20) received individualized vestibular rehabilitation for 30 minutes, three times daily for 12 weeks. The VRT+VitD group (n=21) received the same VRT protocol plus a weekly oral dose of 50,000 IU of 25(OH)D for 12 weeks. Outcomes were assessed pre- and post-intervention using the Dizziness Handicap Inventory (DHI), Vertigo Symptom Scale-short form (VSS-sf), and affected canal vestibulo-ocular reflex gains with video head impulse test, within- and between-groups. Results: Both groups improved significantly across all measurements. The VRT+VitD group showed a normal serum level of vitamin D post-intervention (39.36±3.06; p<0.001) and greater improvements in subjective symptom reduction (DHI; p=0.023; partial η²=0.126), and VOR gains (p<0.001 with partial η²=0.459, 0.576, and 0.197 for lateral, anterior, and posterior canals, respectively) compared to the VRT group. Conclusion: Correcting vitamin D deficiency supports and potentially enhances the effects of vestibular rehabilitation in patients with vestibular neuritis, although these outcomes should be interpreted with caution due to the study’s limitations. https://avr.tums.ac.ir/index.php/avr/article/view/1533