Comparative Study on the Roles of the Number of Accelerations and Rotation Angle in the Treatment Maneuvers for Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo

ORL ◽  
2015 ◽  
Vol 78 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Liang Tian ◽  
Hai-Bin Sheng ◽  
Jing Wang ◽  
Xu Luo ◽  
Jing Yu ◽  
...  
2021 ◽  
Vol 9 (3) ◽  
pp. 75-80
Author(s):  
Mustafa Caner Kesimli

OBJECTIVE: This study aimed to compare the effectiveness of the Epley maneuver with the Semont maneuver in the treatment of posterior semicircular canal benign paroxysmal positional vertigo and observe differences in the resolution time of symptoms in the short-term follow-up. METHODS: Sixty patients with posterior semicircular canal benign paroxysmal positional vertigo (23 males, 37 females; median age: 44.9 years; range, 14 to 80 years) were included in the prospective randomized comparative study conducted in our clinic between April 2019 and October 2019. Diagnosis and treatment maneuvers were performed under videonystagmography examination. Participants were randomly selected after the diagnostic tests for the Epley maneuver and the Semont maneuver treatment groups. RESULTS: In the evaluation of vertigo with videonystagmography, 25 (83.3%) patients in the Epley maneuver group and 20 (66.6%) patients in the Semont maneuver group recovered in the one-week follow-up, and 28 (93.3%) patients in the Epley maneuver group and 24 (80%) patients in the Semont maneuver group recovered in the two-week follow-up. All patients in the Epley maneuver group recovered at the end of one month; four patients in the Semont maneuver group still had vertiginous symptoms (100% vs. 86.6%, p=0.04). There was a statistically significant difference between the Epley and Semont groups regarding visual analog scores at the one-week, two-week, and one-month follow-ups (p=0.002, p<0.001, p=0.001, respectively). CONCLUSION: The Epley maneuver was significantly more effective than the Semont maneuver in resolving vertigo in the short-term treatment of posterior semicircular canal benign paroxysmal positional vertigo.


2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Francisco Carlos Zuma e Maia ◽  
Pedro Luiz Mangabeira Albernaz ◽  
Renato Valério Cal

The objective of the present study is to analyze the quantitative vestibulo-ocular responses in a group of patients with benign paroxysmal positional vertigo (BPPV) canalolithiasis and compare these data with the data of the tridimensional biomechanical model. This study was conducted on 70 patients that presented idiopathic posterior semicircular canal canalolithiasis. The diagnosis was obtained by Dix- Hallpike maneuvers recorded by videonystagmograph. The present study demonstrates that there is a significant correlation between the intensity of the nystagmus and its latency in cases of BPPV-idiopathic posterior semicircular canal canalolithiasis type. These findings are in agreement with those obtained in a tridimensional biomechanical model and are not related to the patients’ age.


Author(s):  
Robert W. Baloh

Near the turn of the 21st century, as more physicians began performing the Epley and Semont maneuvers for treatment of benign paroxysmal positional vertigo (BPPV), it became apparent that the procedures could be done at the time of initial examination without the need for sedation or vibration. Furthermore, modified versions of the maneuvers evolved that were more effective and easier to perform. There are clear similarities in these modified repositioning maneuvers. BPPV nearly always results from otoconial debris within the posterior semicircular canal because this is the canal in which it is most easily trapped. Although less common, there are horizontal and anterior semicircular canal variants of BPPV, and otolithic debris can become attached to the cupula, producing a true cupulolithiasis. The nystagmus is in the plane of the affected canal; the nystagmus is transient when the debris is freely floating and persistent when debris is attached to the cupula.


Author(s):  
Robert W. Baloh

In 1949, Harold Schuknecht completed his residency in John Lindsay’s Otolaryngology Department at the University of Chicago and stayed first as a clinical instructor and then as an assistant professor. Schuknecht reviewed the temporal bone specimens from the patient reported by his mentor, John Lindsay, and from patients reported by Charles Hallpike and colleagues and was struck by the similarity in the pathologic changes. He concluded that in each case damage to the labyrinth resulted from occlusion of the anterior vestibular artery. Schuknecht believed that the delayed positional vertigo that occurred in these cases must have originated from the posterior semicircular canal. He reasoned that with degeneration of the superior vestibular labyrinth, otoconia would be released from the otolithic membrane of the utricular macule and that, in certain positions of the head, the otoconia would respond to gravity and thereby activate the cupula of the posterior semicircular canal.


2008 ◽  
Vol 122 (12) ◽  
pp. 1295-1298 ◽  
Author(s):  
S G Korres ◽  
C E Papadakis ◽  
M G Riga ◽  
D G Balatsouras ◽  
D G Dikeos ◽  
...  

AbstractObjective:The aim of this study was to investigate the frequency of posterior semicircular canal benign paroxysmal positional vertigo in each ear, and to assess the association between the ear affected by benign paroxysmal positional vertigo and the head-lying side during sleep onset. Based on a previous study which used objective methods to prove the preference of the elderly for the right head-lying side during sleep, we hypothesised that a predominance of the same head-lying side in benign paroxysmal positional vertigo patients may affect the pathophysiology of otoconia displacement.Study design:We conducted a prospective study of out-patients with posterior semicircular canal benign paroxysmal positional vertigo, confirmed by a positive Dix–Hallpike test.Methods:One hundred and forty-two patients with posterior semicircular canal benign paroxysmal positional vertigo were interviewed about their past medical history, focusing on factors predisposing to benign paroxysmal positional vertigo. All patients included in the study were able to define a predominant, favourite head-lying side, right or left, during sleep onset.Results:The Dix–Hallpike test was found to be positive on the right side in 82 patients and positive on the left side in 54; six patients were found to be positive bilaterally. During sleep onset, 97 patients habitually laid their head on the right side and the remaining 45 laid their head on the left. The association between the affected ear and the head-lying side during sleep onset was statistically significant (p < 0.001).Conclusions:Our study found a predominance of right-sided benign paroxysmal positional vertigo, a subjective preference amongst patients for a right head-lying position during sleep onset, and an association between the ear affected by benign paroxysmal positional vertigo and the preferred head-lying side during sleep onset. The clinical and therapeutical implications of this observation are discussed.


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