Treatment of Patients With Benign Paroxysmal Positional Vertigo and Severe Immobility Using the Particle Repositioning Chair: A Retrospective Cohort Study

Abstract

Objective: To report treatment of benign paroxysmal positional vertigo (BPPV) in patients unable to undergo traditional canalith repositioning maneuvers (CRMs) using a particle repositioning chair (PRC). Methods: A retrospective chart review was conducted at a single high-volume otology practice of patients diagnosed with BPPV from 2007 to 2017 with immobility prohibiting use of traditional CRMs. Patients were diagnosed and treated using a PRC, and outcome measures including resolution, recurrence, and number of treatment visits were recorded. Results: A total of 34 patients meeting criteria were identified, 24 of whom had cervical spine disease and 10 of whom had other prohibitive immobility. Symptoms were present for between 5 days and 11 years at presentation, with mean and median of 552 and 90 days, respectively. Symptoms resolved in 68% of patients and recurred in 13% of those patients. Most patients required 1 treatment visit. Conclusions: Successful treatment of patients with BPPV and concomitant immobility prohibiting traditional CRMs is reported using the PRC. Benign paroxysmal positional vertigo in the setting of immobility is an indication for treatment with a PRC if available.

Is a Mechanical Rotational Chair Superior to Manual Treatment Maneuvers on an Examination Bed in the Treatment of Benign Paroxysmal Positional Vertigo?

“…Theoretically, this may improve treatment efficacy by loosening and acceleration of the otoconial debris within the SCCs (6,14,15). Furthermore, repositioning chairs allow treatment of immobile patients, who cannot undergo standard treatments with manual canalith repositioning maneuvers (19). Data from our clinic has showed that the TRV-chair is very efficient in the treatment of intractable BPPV cases (18).…”

Repositioning Chairs in the Diagnosis and Treatment of Benign Paroxysmal Positional Vertigo - A Systematic Review

“…One of the aims of this review was also to examine the indications for treatment in a repositioning chair, as very different indications for chair treatment currently exist. 14 It seems that the indications for repositioning chairs varied in the included studies. Specifically, 2 studies reported indication of treatment due to inability of successful manual CRP with cervical or lumbar spine disease.…”

“…For 1 of the studies, this can be explained by low sample size ( n = 34) or a high number of cases of non p -BPPV (38.2%) and multi-canal involvement (14.7%). 14 Another study had a non p -BPPV group of 19%, and 7% of subjects also suffered from Meniere’s disease, which could have contributed to the low success rate. 15 A lower rate of symptom relief was found in the group of patients with multi-canal affection.…”

“…Co-morbidities can be a primary indication for chair treatment. 14 , 16 Likewise, patients with refractory BPPV also showed to benefit from being referred to treatment in repositioning chairs, which therefore is a viable indication. 8 ,15, 16 …”

Outcomes of Treatment of Multicanal Benign Paroxysmal Positional Vertigo by Means of TRV Chair

“…The advantages of the repositioning chairs over classical maneuvers include analytical feasibility and the treatment of people with low back and neck problems that make them unsuitable for manual treatments. Also, they have potential utility for complicated BPPV cases [Luryi et al, 2018;West et al, 2019;Abdulovski and Klokker, 2021]. Therefore, the aim of the present study was to analyze the outcomes of treatment of MC-BPPV with the TRV Chair and compare those results with manual maneuvers.…”