ABSTRACT
Canalith Repositioning and Semont Liberatory Maneuvers have been shown to be highly efficacious in the successful treatment of Benign Paroxysmal Positional Vertigo (BPPV). The differentiation of canalalithiasis, cupulolithiasis, and correct identification of canal involvement, particularly through the use of Video-oculography, have enhanced treatment decisions and outcomes.
Since 1994, approximately 700 BPPV patients have been treated at the authors' clinical facility. An anecdotal study of 376 of these patients followed over a 7-year period is presented. The patients in the historical study all presented with BPPV- PC and were treated with modified Canalith Repositioning Maneuver and Semont Liberatory Maneuver treatment procedures. The review indicated no significant differences in treatment outcomes between the two procedures. Seventy-nine percent of the patients required only one treatment, while 17% required two treatments, 3.5% required three treatments, and 0.05% required four treatments. The average number of treatments was 1.3. The SLM did show a reduced recurrence rate compared to the CRP method.
KEYWORDS
Benign Paroxysmal Positional Vertigo (BPPV) - canalalithiasis - cupulolithiasis - otolith
REFERENCES
-
1
Bath A P, Walsh R M, Ranalli P.
Experience from a multidisciplinary ``dizzy'' clinic.
Am J Otol .
2000;
21
92-97
-
2
Li J C, Li C J, Epley J, Weinberg L.
Cost-effective management of benign positional vertigo using canalith repositioning.
Otolaryngol Head Neck Surg .
2000;
122
334-339
-
3
Barany R.
Diagnose von Krankeitserschernungenin Bereiche des Otolithenapparaten.
Acta Otolaryngol (Stockh) .
1921;
2
434-437
-
4
Dix M R, Hallpike C S.
The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system.
Ann Otol Rhinol Laryngol .
1952;
61
987-1016
-
5
Schuknecht H F.
Cupulolithiasis.
Arch Otolaryngol .
1969;
90
113-126
-
6
Baloh R W.
Harold Schuknecht and pathology of the ear.
Otology and Neurotology .
2001;
22
113-122
-
7
Parnes L S, McClure J A.
Free-floating endolymph particles: a new operative finding during posterior canal occlusion.
Laryngoscope .
1992;
102
988-992
-
8
Hall S F, Rudy R RF, McClure J A.
The mechanics of benign paroxysmal positional vertigo.
J Otolaryngol .
1979;
8
151-158
-
9
Gans R E.
Overview of BPPV: pathophysiology and diagnosis.
The Hearing Review .
2000;
7(8)
38-43
-
10
Brandt T, Daroff R B.
Physical Therapy for Benign Paroxysmal Positional Vertigo.
Arch Otolaryngol .
1980;
106
484
-
11
Semont A, Freyss G, Vitte E.
Curing the BPPV with a Liberatory Maneuver.
Adv Otorhinolaryngol .
1988;
42
390-393
-
12
Epley J M.
The Canalith Repositioning Procedure for treatment of benign paroxismal positional vertigo.
Arch Otolaryngol .
1993;
119
450-454
-
13
Herdman S J, Tusa R J, Zee D S.
Single treatment approaches to benign paroxysmal positional vertigo.
Arch Otolaryngol .
1993;
119
450-454
-
14
Steenerson R L, Cronin G W.
Comparison of the Canalith Repositioning Procedure and Vestibular Habituation Training in forty patients with benign paroxysmal positional vertigo.
Otolaryngol Head Neck Surg .
1996;
114
61-64
-
15
Coppo C F, Singarelli S, Fracchia P.
Benign paroxismal positional vertigo: follow-up of 165 cases treated by Semont's Liberating Maneuver.
Acta Otorhinolgaryngol Ital .
1996;
16
508-512
-
16
Lempert T, Wolsley C, Davies R, Gresty M A, Bronstein A M.
Three hundred sixty-degree rotation of the posterior semicircular canal for treatment of benign positional vertigo: a placebo-controlled trial.
Neurology .
1997;
49
729-733
-
17
Cohen H S, Jerabek J.
Efficacy of treatments for posterior canal benign paroxysmal positional vertigo.
Laryngoscope .
1999;
109
584-590
-
18
Gall R M, Ireland D J, Robertson D D.
Subjective visual vertical in patients with benign paroxysmal positional vertigo.
J Otolaryngol .
1999;
28
162-165
-
19
Wolf J S, Boyev K P, Manokey D E.
Success of the modified Epley Maneuver in treating benign paroxysmal positional vertigo.
Laryngoscope .
1999;
109
900-903
-
20
Dornhoffer J L, Colvin G B.
Benign paroxysmal positional vertigo and Canalith Repositioning : clinical correlations.
Am J Otol .
2000;
21
230-233
-
21
Macias J D, Lambert K M, Massingale S, Ellensohn A, Fritz J A.
Variables affecting treatment in benign paroxysmal positional vertigo.
Laryngoscope .
2000;
110
1921-1924
-
22
Nunez R A, Cass S P, Furman J M.
Short and long term outcomes of Canalith Repositioning for benign paroxysmal positional vertigo.
J Otolaryngol .
2000;
122
647-652
-
23
O'Reilly R, Elford B, Slater R.
Effectiveness of Particle Repositioning Maneuver in subtypes of benign paroxysmal positional vertigo.
Laryngoscope .
2000;
110
1385-1388
-
24
Tirelli G, D'Orlando E, Zarcone O, Giacomarro V, Russolo M.
Modified Particle Repositioning Procedure.
Laryngoscope .
2000;
100
462-467
-
25
Oghalai J S, Manolidis S, Barth J, Stewart M, Jenkins H A.
Unrecognized benign paroxysmal positional vertigo in elderly patients.
Otolaryngol Head Neck Surg .
2000;
122(5)
630-634
-
26
Gans R E, Crandall C.
Overview of BPPV: evaluating treatment outcomes with clinimetrics.
The Hearing Review .
2000;
7(11)
50-54
-
27 Ware J E. How to Score the Revised MOS Short Form Health Scales (SF-36) Boston: The Health Institute, New England Medical Center Hospitals; 1988 .
-
28
Herdman S J, Tusa R J.
Complications of the Canalith Repositioning Procedure.
Arch Otolaryngol Head Neck Surg .
1996;
122(3)
281-286
-
29
Li J C.
Mastoid Oscillation: a critical factor for success in Canalith Repositioning Procedure.
Otolaryngol Head Neck Surg .
1995;
112
670-675
-
30
Sargent E W, Bankaitis A E, Hollenbeak C S, Currens J W.
Mastoid oscillation in canalith reporitioning for paroxysmal positional vertigo.
Otology and Neurotology .
2001;
22
205-209
-
31
Gans R E.
Overview of BPPV: treatment methodologies.
The Hearing Review .
2000;
7(9)
34-39
-
32
Zucca G, Valli S, Valli P, Perin P, Mira E.
Why do benign paroxysmal positional vertigo episodes recover spontaneously?.
J Vestib Res .
1998;
8
325-329
-
33
Nuti D, Nati C, Passali D.
Treatment of benign paroxysmal positional vertigo: no need for post-maneuver restrictions.
J Otolaryngol .
2000;
122
440-444
-
34
Appiani G C, Catania G, Gagliardi M.
A liberatory maneuver for the treatment of horizontal canal paroxysmal positional vertigo.
Otology and Neurotology .
2001;
22
66-69
-
35
Fife T D.
Recognition and management of horizontal canal benign positional vertigo.
Am J Otol .
1998;
19
345-351
-
36
Vannucchi P, Giannoni B, Pagnini P.
Treatment of horizontal semicircular canal benign paroxysmal positional vertigo.
J Vestib Res .
1997;
7
1-6
-
37
DelaMeilleure G, Dehaene I, Depondt M.
Benign paroxysmal positional vertigo of the horizontal canal.
J Neurol Neurosurg Psychiatry .
1996;
60
68-71
-
38
Nuti D, Vannucchi P, Pagnini P.
Benign paroxysmal positional vertigo of the horizontal canal: a form of canalolithiasis with variable clinical features.
J Vestib Res .
1996;
6
173-184
-
39
Steddin S, Ing D, Brandt T.
Horizontal canal benign paroxysmal positional vertigo (h-BPPV): transition of canalolithiasis to cupulolithiasis.
Ann Neurol .
1996;
40
918-922
-
40
Strupp M, Brandt T, Steddin S.
Horizontal canal benign paroxysmal positional vertigo: reversible ipsilateral caloric hypoexcitability caused by canalolithiasis.
Neurology .
1995;
45
2072-2076
-
41
Lempert T, Tiel-Wick K.
A positional maneuver for treatment of horizontal canal benign positional vertigo.
Laryngoscope .
1996;
106
476-478
-
42
Baloh R W, Jacobson K, Honrubia V.
Horizontal semicircular canal variant of benign positional vertigo.
Neurology .
1993;
43
2542-2549
-
43
McClure J A.
Horizontal canal BPPV.
J Otolaryngol .
1985;
14
30-35
-
44
Herdman S J, Tusa R J.
Complications of the Canalith Repositioning Procedure.
Arch Otolaryngol Head Neck Surg .
1996;
122(3)
281-286
-
45
Norre M E, Beckers A.
Benign Paroxysmal Positional Vertigo in the elderly.
J Am Geratr Soc .
1988;
36
425-429
-
46
Troost B T, Patton J M.
Exercise therapy for Positional Vertigo.
Neurology .
1992;
42
1441-1444
-
47
Blatt P J, Gergakakis G A, Herdman S J, Clendaniel R A, Tusa R J.
The effect of the Canalith Repositioning Maneuver on resolving postural instability in patients with Benign Paroxysmal Positional Vertigo.
Am J Otol .
2000;
21
356-363
-
48
Gross E M, Ress B D, Viirre E S, Nelson J R, Harris J P.
Intractable Benign Paroxysmal Positional Vertigo in patients with Meniere's disease.
Laryngoscope .
2000;
110
655-659
1 Patients are provided with a soft cervical collar.
