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European Archives of Oto-Rhino-Laryngology

23.04.2024 | Otology

To compare the recovery rates of modified Epley’s against Semont’s manoeuvres in patients with posterior canal benign paroxysmal positional vertigo: a randomized clinical trial

verfasst von: Bandana Thakur, Poonam Raj, Kamalpreet Singh, Viswanathan Anand

Erschienen in: European Archives of Oto-Rhino-Laryngology

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Abstract

Introduction

Benign paroxysmal positional vertigo (BPPV) is one of the commonest causes of peripheral vertigo. It is treated with various canalolith repositioning manoeuvres by changing the head positions to allow the otoconial debris to fall back from the affected canal back to the utricle. The present study has compared the rate of recovery of vertigo with modified Epley’s manoeuvres as compared to Semont’s manoeuvre in patients with posterior canal BPPV.

Materials and methods

One hundred and seventy patients diagnosed by positive Dix–Hallpike test as posterior canal BPPV were included in this clinical trial. Subjective analysis of vertigo was done using visual analogue scale. 85 patients each were recruited in two arms by simple randomization using lottery method. Modified Epley’s manoeuvre was administered to one group and Semont’s manoeuvre to the other. They were recalled after 2 weeks for clinical assessment with repeat Dix–Hallpike and VAS.

Results

Repeat Dix–Hallpike manoeuvres after two weeks revealed that 95.3 and 90.6% patients improved in Modified Epley’s and Semont’s group, respectively. After the second manoeuvre, the resolution rate was significantly higher in Semont’s manoeuvre 100% (8 out of 8 patients), as compared to 25% (1 out of 4 patients) in Modified Epley’s manoeuvre. Comparison of the mean values of VAS day 0 and VAS 2 weeks has been found to be statistically significant (p value of < 0.001).

Conclusion

Both Epley’s and Semont’s manoeuvre are equally efficacious in treatment of BPPV. However, use of Semont’s manoeuvre required fewer repeat manoeuvres for complete resolution of symptoms in patients. The Semont’s manoeuvre is also comparatively easier to perform with less number of position changes, takes less time, and has no requirement of post-manoeuvre mobility restrictions. Hence, it is recommended that Semont’s manoeuvre can be routinely used for the management of PC BPPV especially in older population and patients with spinal problems.

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Titel: To compare the recovery rates of modified Epley’s against Semont’s manoeuvres in patients with posterior canal benign paroxysmal positional vertigo: a randomized clinical trial
verfasst von: Bandana Thakur
Poonam Raj
Kamalpreet Singh
Viswanathan Anand
Publikationsdatum: 23.04.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: European Archives of Oto-Rhino-Laryngology
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-024-08657-2

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