Postional Maneuver For The Treatment Of Benign Paroxysmal Positional Vertigo: A Clinical Analysis Of 23 Cases

Purpose: Benign paroxysmal positional vertigo is an idiopathic disorder caused by disorder of vestibular organ in the inner ear. Its symptoms include repeated episodes of positional vertigo, that is, of a spinning sensation caused by changes of head position. BPPV is the most common variety of peripheral vertigo. The Dix-Hallpike maneuver is the golden standard clinical test for BPPV. Canalith repositioning procedure(CRP) is the main treatment of BPPV all over the world. The definite curative effect has been proved by some literature.As having the highest incidence in all varieties of vertigo, BPPV also has two kinds of pathological mechanism, one is that otolith particles fall from the utricle into semicircular canal, the other is that otolith particles adhere to crista ampullaris. There is still no complete epidemiological data about BPPV in our country, on the Branch of the Chinese Medical Association of 2006, experts from otorhinolaryngology developed diagnostic standard and treatment assessment criteria. BPPV develops a lot as the new guidelines becoming available, however there are dozens of clinical papers on BPPV, together with a number of promblems to resolve. In this study, considering pertinent literature, we will discuss CRP treatment effect on BPPV.Methods: We chose 23 patients from May 2009 to March 2010 who had vertigo complaint and diagnosed as BPPV through detailed history, physical examination and video-nystagmography in our department. It contains 11 males and 12 females, ageing from 32 to 69 years, mean age 49 years, 18 cases of posterior semicircular canal BPPV versus 5 cases of horizontal canal BPPV,and 10 cases of left side versus 13 cases of right side . Time from vertigo onset to treatment is from 1 day to 40 years.Result: 23 patients were treated by CRP, one months later, we fellow up all cases, of which 19 cases recovered (82.61%), among them, 15 cases(78.95%) without recurrence after the first treatment, and the other 4 cases (21.05%) were symptoms-disappeared after 2~3 times CRP; of which 4 cases (17.39%) improved; total effective rate was 100%. 19 cases don't relapse after 1 month's follow-up.5 of the patients nausea after CRP,among them 2 patients have vomiting,one patient has pale of face, one patient cannot walk steadily, all of them recover after a break.Conclusion: Most patients of BPPV can be cured by CRP,which is an effective, simple and safe method to treat BPPV, CRP is the first choice of the treatment of BPPV, PC-BPPV is more common than HC-BPPV.