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

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
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加速次数与旋转角度在后半规管良性阵发性位置性眩晕治疗中作用的对比研究

DOI:
10.1159/000442091
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发表时间:
2016-01-01
影响因子:
1.3
通讯作者:
Chi, Fang-Lu
Chi, Fang-Lu
中科院分区:
医学4区
文献类型:
--
作者:
Tian, Liang;Sheng, Hai-Bin;Chi, Fang-Lu

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Aims: This study aims to investigate the roles of the number of accelerations and rotation angle in the treatment of posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV). Methods: We enrolled 344 patients with unilateral PC-BPPV. Of these, 167 patients in the simple-step maneuver (SSM) group were accelerated twice and rotated 120° per step, whereas 177 patients in the multi-step maneuver (MSM) group were accelerated 4 times and rotated 60° per step. Dix-Hallpike (DH) tests were performed to categorize the treatment outcome as follows: ‘symptom free' if the result was negative, ‘symptom persistent' if the result remained positive after performing the maneuver 3 times or ‘canal conversion' if horizontal nystagmus was evoked. Results: Of the patients in the SSM and MSM groups, 78.4 and 91.5% became symptom free, respectively, while canal conversion occurred in 13.8 and 5.1%, respectively (p = 0.003, χ2 test). The success rate after performing the maneuver once was 57.1% in the MSM and 32.3% in the SSM symptom-free patients (p = 0.001, χ2 test). One month after the treatment, 22.0 and 9.6% of the SSM and MSM patients had symptom relapse, respectively (p = 0.007, χ2 test). Conclusions: More accelerations and a smaller rotation angle improved the effectiveness and efficiency of the repositioning maneuvers and reduced canal conversion.