Repositioning chairs in benign paroxysmal positional vertigo: implications and clinical outcome

TY - JOUR

T1 - Repositioning chairs in benign paroxysmal positional vertigo

T2 - implications and clinical outcome

AU - West, Niels

AU - Hansen, Søren

AU - Møller, Martin Nue

AU - Bloch, Sune Land

AU - Klokker, Mads

PY - 2016/3/1

Y1 - 2016/3/1

N2 - The objective was to evaluate the clinical value of repositioning chairs in management of refractory benign paroxysmal positional vertigo (BPPV) and to study how different BPPV subtypes respond to treatment. We performed a retrospective chart review of 150 consecutive cases with refractory vertigo referred to our clinic within a 10-month period. The BPPV patients were managed with classical manual manoeuvres, the Epley Omniax(®) rotator (EO) or the TRV chair (TRV). In addition, a comprehensive review of the literature was performed. BPPV was identified in 95 cases. The number of needed treatments for posterior canalolithiasis versus posterior cupulolithiasis, horizontal cupulolithiasis and multi-canal affection was significant (p < 0.01). Thirty-seven (38 %) patients required only one repositioning manoeuvre and the overall symptom relief was 91.7-100 % after 3 treatments. Eleven patients (12 %) experienced relapse within the ½-year follow-up period. Horizontal cupulolithiasis and multi-canal affection constituted the most resilient cases. The literature search identified 9 repositioning chair studies. The EO and the TRV are highly valuable assets in diagnosis and management of BPPV of particularly complex and refractory cases. However, further validation is anticipated through controlled clinical trials.

AB - The objective was to evaluate the clinical value of repositioning chairs in management of refractory benign paroxysmal positional vertigo (BPPV) and to study how different BPPV subtypes respond to treatment. We performed a retrospective chart review of 150 consecutive cases with refractory vertigo referred to our clinic within a 10-month period. The BPPV patients were managed with classical manual manoeuvres, the Epley Omniax(®) rotator (EO) or the TRV chair (TRV). In addition, a comprehensive review of the literature was performed. BPPV was identified in 95 cases. The number of needed treatments for posterior canalolithiasis versus posterior cupulolithiasis, horizontal cupulolithiasis and multi-canal affection was significant (p < 0.01). Thirty-seven (38 %) patients required only one repositioning manoeuvre and the overall symptom relief was 91.7-100 % after 3 treatments. Eleven patients (12 %) experienced relapse within the ½-year follow-up period. Horizontal cupulolithiasis and multi-canal affection constituted the most resilient cases. The literature search identified 9 repositioning chair studies. The EO and the TRV are highly valuable assets in diagnosis and management of BPPV of particularly complex and refractory cases. However, further validation is anticipated through controlled clinical trials.

U2 - 10.1007/s00405-015-3583-z

DO - 10.1007/s00405-015-3583-z

M3 - Journal article

C2 - 25749489

SN - 0937-4477

VL - 273

SP - 573

EP - 580

JO - European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery

JF - European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery

IS - 3

ER -