Efficacy of particle repositioning manoeuvres in benign positional paroxysmal vertigo: A revision of 176 cases treated in a tertiary care centre.

Autor: Carnevale C; Servicio de Otorrinolaringología y Patología Cervicofacial, Hospital Universitario Son Espases, Palma de Mallorca, España. Electronic address: claudio.carnevale.orl@gmail.com., Arancibia-Tagle DJ; Servicio de Otorrinolaringología y Patología Cervicofacial, Hospital Universitario Son Espases, Palma de Mallorca, España., Rizzo-Riera E; Servicio de Otorrinolaringología y Patología Cervicofacial, Hospital Universitario Son Espases, Palma de Mallorca, España., Til-Perez G; Servicio de Otorrinolaringología y Patología Cervicofacial, Hospital Universitario Son Espases, Palma de Mallorca, España., Sarría-Echegaray PL; Servicio de Otorrinolaringología y Patología Cervicofacial, Hospital Universitario Son Espases, Palma de Mallorca, España., Rama-Lopez JJ; Servicio de Otorrinolaringología y Patología Cervicofacial, Hospital Universitario Son Espases, Palma de Mallorca, España., Quer-Canut S; Servicio de Otorrinolaringología y Patología Cervicofacial, Hospital Universitario Son Espases, Palma de Mallorca, España., Fermin-Gamero G; Servicio de Urgencias, Hospital Universitario Son Espases, Palma de Mallorca, España., Tomas-Barberan MD; Servicio de Otorrinolaringología y Patología Cervicofacial, Hospital Universitario Son Espases, Palma de Mallorca, España.
Jazyk: English; Spanish; Castilian
Zdroj: Acta otorrinolaringologica espanola [Acta Otorrinolaringol Esp (Engl Ed)] 2018 Jul - Aug; Vol. 69 (4), pp. 201-207. Date of Electronic Publication: 2017 Sep 29.
DOI: 10.1016/j.otorri.2017.06.001
Abstrakt: Introduction and Objectives: Benign paroxysmal positional vertigo is the most common peripheral vertigo disease. The aim of this paper is to review the results obtained with the different specific particle repositioning manoeuvres, evaluating the possible risk factors linked to a poorer prognosis.
Methods: One hundred and seventy-six patients with a diagnosis of benign paroxysmal positional vertigo were reviewed retrospectively, of whom 150 had vertigo of the posterior canal, 20 had vertigo of the horizontal canal, 3 had vertigo of the superior canal, and 3 had a double vertigo. The Epley manoeuvre was used to treat the posterior and superior canals, and Lempert manoeuvre was used to treat the horizontal canal. An imaging study by nuclear magnetic resonance with gadolin was always used in refractory cases.
Results: The Epley manoeuvre showed an efficacy of 74.6 and 100% at first attempt for posterior and superior canals respectively. The efficacy of the Lempert manoeuvre for the horizontal canal was 72.72% in the patients with canalolithiasis, and 58.33% in the patients with cupulolithiasis. The treatment of patients with more than one affected canal and a history of surgery in the previous month was more difficult.
Conclusions: Particle repositioning manoeuvres show a very high success rate, allowing better results in the treatment of the posterior canal. We need more studies to confirm the suspicion that surgery may be a factor of poorer prognosis.
(Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.)
Databáze: MEDLINE
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