What Is the True Incidence of Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo?

Çakır, Burak Ömür; Ercan, Ibrahim; Çakır, Zeynep Alkan; Civelek, Senol; Sayın, İbrahim; Turgut, Suat

doi:10.1016/j.otohns.2005.07.045

Cited by 128 publications

(113 citation statements)

References 14 publications

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“…In view of previous reports on the incidence of HC-BPV in the western countries [6,12,15,22], the number of patients recruited in our study from seven dizziness clinics over a 9-month period seems larger than expected. However, in a recent multicenter study conducted in Korea, the horizontal canal was involved in 32% of patients and half of them were of apogeotropic type [21].…”

Section: Mastoid Oscillation During Brandt-daroff Exercisementioning

confidence: 80%

Treatment of apogeotropic benign positional vertigo: comparison of therapeutic head-shaking and modified Semont maneuver

Kim

Jeong

et al. 2009

J Neurol

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Several methods of physiotherapy have been advanced for apogeotropic type benign positional vertigo involving the horizontal semicircular canal (HC-BPV). The aim of this study was to determine the therapeutic efficacies of the proposed maneuvers in apogeotropic HC-BPV. Using a prospective randomized trial involving seven nationwide dizziness clinics in Korea, we compared the immediate efficacies of head-shaking and modified Semont maneuvers in 103 consecutive patients with apogeotropic HC-BPV. We also determined an additional therapeutic benefit of mastoid oscillation while the patients without response to both maneuvers were performing the Brandt-Daroff exercise. Successful treatment was defined as resolution of positional vertigo and nystagmus, or as transition into geotropic HC-BPV. Results showed that head shaking was more effective than the modified Semont maneuver (37.3 vs. 17.3%, P = 0.02). However, therapeutic efficacy did not differ between the maneuvers after the initial non-responders switched over to the other maneuver (23.3 vs. 25.0%, P = 0.861). Mastoid oscillation provided no additional benefit while the patients without response to both maneuvers were performing the Brandt-Daroff exercise. Most positional vertigos resolved within a week (89.4%) irrespective of the treatment modalities applied and all showed resolution within 28 days. The head-shaking maneuver described here proved more effective than the modified Semont maneuver in treating apogeotropic HC-BPV. Mastoid vibration conferred no additional benefit during the Brandt-Daroff exercise.

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Section: Mastoid Oscillation During Brandt-daroff Exercisementioning

confidence: 80%

Treatment of apogeotropic benign positional vertigo: comparison of therapeutic head-shaking and modified Semont maneuver

Kim

Jeong

et al. 2009

J Neurol

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“…Two investigations report statistically significant benefit from use of postmaneuver restrictions. 11,207 Devaiah and Andreoli conducted a meta-analysis based on data from 6 investigations with 523 patients meeting all inclusion criteria. 208 With this analysis, they found no effect when outcomes from the 2 groups were compared (ie, restrictions vs no restrictions).…”

mentioning

confidence: 99%

Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update)

Bhattacharyya¹,

Gubbels

Schwartz

et al. 2017

Otolaryngol.--head neck surg.

570

776

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Objective. This update of a 2008 guideline from the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations to benign paroxysmal positional vertigo (BPPV), defined as a disorder of the inner ear characterized by repeated episodes of positional vertigo. Changes from the prior guideline include a consumer advocate added to the update group; new evidence from 2 clinical practice guidelines, 20 systematic reviews, and 27 randomized controlled trials; enhanced emphasis on patient education and shared decision making; a new algorithm to clarify action statement relationships; and new and expanded recommendations for the diagnosis and management of BPPV.Purpose. The primary purposes of this guideline are to improve the quality of care and outcomes for BPPV by improving the accurate and efficient diagnosis of BPPV, reducing the inappropriate use of vestibular suppressant medications, decreasing the inappropriate use of ancillary testing such as radiographic imaging, and increasing the use of appropriate therapeutic repositioning maneuvers. The guideline is intended for all clinicians who are likely to diagnose and manage patients with BPPV, and it applies to any setting in which BPPV would be identified, monitored, or managed. The target patient for the guideline is aged ≥18 years with a suspected or potential diagnosis of BPPV. The primary outcome considered in this guideline is the resolution of the symptoms associated with BPPV. Secondary outcomes considered include an increased rate of accurate diagnoses of BPPV, a more efficient return to regular activities and work, decreased use of inappropriate medications and unnecessary diagnostic tests, reduction in recurrence of BPPV, and reduction in adverse events associated with undiagnosed or untreated BPPV. Other outcomes considered include minimizing costs in the diagnosis and treatment of BPPV, minimizing potentially unnecessary return physician visits, and maximizing the health-related quality of life of individuals afflicted with BPPV.Action Statements. The update group made strong recommendations that clinicians should (1) diagnose posterior semicircular canal BPPV when vertigo associated with torsional, upbeating nystagmus is provoked by the Dix-Hallpike maneuver, performed by bringing the patient from an upright to supine position with the head turned 45° to one side and neck extended 20° with the affected ear down, and (2) treat, or refer to a clinician who can treat, patients with posterior canal BPPV with a canalith repositioning procedure. The update group made a strong recommendation against postprocedural postural restrictions after canalith repositioning procedure for posterior canal BPPV. The update group made recommendations that the clinician should (1) perform, or refer to a clinician who can perform, a supine roll test to assess for lateral semicircular canal BPPV if the patient has a history compatible with BPPV and the Dix-Hallpike test exhibits horizontal or no nystagmus; (2) differentiate...

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“…The most common form of BPPV involves the posterior semicircular canal (PSC) while the horizontal semicircular canal (HSC) is involved in a percentage that varies between 5 and 22% [De La Meilleure et al 1996;Nuti et al, 1998;Casani et al, 2002;Cakir et al, 2006]. The 2 forms differ not only with regard to the nystagmus characteristics (rotatory-upbeating in the former and purely horizontal in the latter) but also in the manner that the form is evoked: supine roll test in cases of HSC-BPPV [Bhattacharyya et al, 2008;Fife et al, 2008] and the DixHallpike maneuver in cases of PSC-BPPV.…”

mentioning

confidence: 99%

Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo: Effectiveness of Two Different Methods of Treatment

Casani¹,

Nacci

Dallan³

et al. 2010

Audiol Neurotol

106

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The aim of this study is to compare the results obtained using 2 methods of treatment for horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV): the barbecue maneuver + forced prolonged position (FPP) versus the Gufoni maneuver. In a randomized prospective clinical trial, we recruited 147 patients affected by HSC-BPPV. The primary outcome was the absence of vertigo and nystagmus upon application of the supine roll test during the follow-up examination. A statistical evaluation was performed in order to assess whether any parameters (e.g. age, duration of nystagmus and symptoms) could influence in any way the results obtained with the 2 methods of treatment. One hundred and three of the 147 patients affected by HSC-BPPV had the geotropic form and 44 had the apogeotropic type. We were able to transform 29 cases of HSC-BPPV from apogeotropic to geotropic. Finally, we obtained a group of 112 patients who were randomized either to the barbecue + FPP procedure (54 patients) or to the Gufoni maneuver (58 patients). The most evident result is the higher percentage of success (statistically significant) with the Gufoni maneuver at the first session of treatment (86 vs. 61%). The final control showed that 44 out of 54 (81%) patients treated with the barbecue maneuver + FPP were symptom free compared to 54 out of 58 (93%) treated with the Gufoni maneuver. Both the barbecue maneuver + FPP and the Gufoni maneuver are valid methods for treating HSC-BPPV (geotropic forms). However, our results also indicate that the Gufoni maneuver has a significant advantage: the success rate shown at the follow-up, although without statistical significance, is undoubtedly higher (93 vs. 81%). This result, together with the fact that it is very easy to perform and that patient compliance is better, make the Gufoni maneuver the method of choice in HSC-BPPV treatment.

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What Is the True Incidence of Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo?

Abstract: C-4.

Cited by 128 publications

References 14 publications

Treatment of apogeotropic benign positional vertigo: comparison of therapeutic head-shaking and modified Semont maneuver

Treatment of apogeotropic benign positional vertigo: comparison of therapeutic head-shaking and modified Semont maneuver

Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update)

Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo: Effectiveness of Two Different Methods of Treatment

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