Diagnosis and management of benign paroxysmal positional vertigo (BPPV).
Diagnosis and management of benign paroxysmal positional vertigo (BPPV).
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发表时间：
2003-09
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通讯作者：
L. Parnes;S. Agrawal;J. Atlas
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作者：
L. Parnes;S. Agrawal;J. Atlas
有令人信服的证据表明，后半规管内自由漂浮的内淋巴颗粒是大多数良性阵发性位置性眩晕(BPPV)的基础。最近的病理发现表明，这些颗粒是耳锥，可能是从椭圆体中的耳石膜移位出来的。它们通常定居在依赖的后管中，使其对重力敏感。超过90%的患者可以通过简单的门诊操作将粒子移回椭圆形体内而成功治疗。我们描述了这一操作的各种技术，以及对不常见的BPPV变种的治疗，如侧管的治疗。对于罕见的BPPV对这些操作无反应并有严重症状的患者，后路闭塞手术是一种安全而高效的手术方式。
There is compelling evidence that free-floating endolymph particles in the posterior semicircular canal underlie most cases of benign paroxysmal positional vertigo (BPPV). Recent pathological findings suggest that these particles are otoconia, probably displaced from the otolithic membrane in the utricle. They typically settle in the dependent posterior canal and render it sensitive to gravity. Well over 90% of patients can be successfully treated with a simple outpatient manoeuvre that moves the particles back into the utricle. We describe the various techniques for this manoeuvre, plus treatments for uncommon variants of BPPV such as that of the lateral canal. For the rare patient whose BPPV is not responsive to these manoeuvres and has severe symptoms, posterior canal occlusion surgery is a safe and highly effective procedure.