| ObjectiveTo evaluate the therapeutic efficacy through comparing the canalith repositioning procedure(CRP) treatment for some of aged patients diagnosed with Benign paroxysmal positional vertigo (BPPV) finally from no-CRP treatment for another patients,we are studying the clinical significance application of the two treatments in BPPV,so as that otolaryngologists and neurologists and Geriatricians could do corresponding intervention for the patients who would suffer from vertigo according to specific condition.MethodsThere were sixty-nine aged patients diagnosed definitely finally with BPPV in the Department of Otorhinolaryngology at the Fourth Center Clinic College of Tianjin Medical University from January2010to January2012, All patients underwent Neurotologic assessment that vertigo were not caused from Central nervous system disorders and The diagnosis of BPPV was made met the diagnostic criteria set by Otolaryngology Head and Neck Surgery branch of CMA(Chinese Medical Association), they were randomly classified into different groups, such group A and group B, whereas35patients of group A received CRP or barbecue rotation treatment until vertigo and positioning nystagmus had disappeared completely, and the patients whom recommended should sleep propped up to prevent repositioned particles from returning after received a CRP. It is advisable for patients to return visit on another day and retest at1-week intervals. It must be understood carefully if the patients still had continuous vertigo provoked by specific changes in head position and were accompanied by a characteristic positioning nystagmus。 If not, it indicated success. If patients complained of motion-evoked dizziness, the Roll test and Dix-Hallpike test were recorded, and if the nystagmus component can be determined with Frenzel’s glasses, the CRP was repeated again, until the vertigo and nystagmus had disappeared completely, and so on. In consideration of features of aged, the patients and their accompanies must be better explained the primary purposes of treatment and the mechanism of BPPV, and patients can be shown how to conduct repositioning techniques in order that patients could cooperate cure. When the CRP were done, technicians and assistants must be gently and accurate and don’t be rude. It’s defined as failed treatment if repeat treatment more than four times while positioning nystagmus and vertigo were still present. As for34patients of group B, because of aged patients with so many complications, they fear the disease itself and vertigo developed from CRP, this group received no-CRP, including a logical physician-controlled treatment, known as the Semont maneuver, and received the medical treatment such as expanding vascular medicine to improve ischemic internal ear, and antihistamines or anticholinergics to anti-vertigo. It is advisable for patients to return visit at intervals regularly and followed-up by call. Clinicians should reassess patients within4-weeks after an initial period of treatment to confirm symptom resolution. Patients’data were analyzed with χ2test to comparing clinic efficacy of two groups. A p value less than0.05was considered to be of statistical significance. Otherwise, it is not of statistical significance.Results1、26were men, the mean age was72.23years,43were women, the mean age was68.67years. Male to female ratio was1:1.654.2、58patients presented with PC-BPPV,9patients presented with HC-BPPV,1patient presented with multiple-canal BPPV,1Cupulolithiasis.3、The dizziness history time from the first attack was2days to30years.4、There were56patients who had complications while29of A grope and27of Bgrope.There was no difference. Complications such as hypertension, TIA, infarct of brain, diabetes mellitus, Dyslipidemia, migraine history, neck diseases, sudden deafness, Meniere disease, labyrinthitis, internal and middle ear mastoid surgery, Head trauma, etc.5、14patients are men and21patients are women from group A, the mean age is70.78years. While12patients are men and22patients are women in grope B, the mean age is69.19years. The success rate of the group A is82.85%for the first time, after2to4times is94.29%, the most is10times. The recurrence rate is25.71% through6-mouths followed up. While the success rate of the group B is55.88%, and the recurrence rate is29.41%. There were statistically significance were observed between the2groups by comparing with clinic efficacy. But there were no statistically significance between the2groups by comparing with the recurrence rate through6-mouths followed up.Conclusions1、The Elderly BPPV patients with relevant diseases are common.2、From the data, it suggested that BPPV patients occurred more in female.3、The prevalence of PC-BPPV was significantly highest compared with others, account for84.06%.4、CRP is a most effective treatment for the aged with BPPV and was applied in the first place.5、For those aged BPPV patients who fear CRP, the treatment of physician-controlled treatment and the medical treatment also effective in some degree. |
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