Treatment of horizontal canal BPPV—a randomized sham-controlled trial comparing two therapeutic maneuvers of different speeds

Laryngoscope Investigative Otolaryngology

article

Camilla Martens¹  Frederik Kragerud Goplen¹  Torbjørn Aasen¹  Rolf Gjestad³  Karl Fredrik Nordfalk⁴  Stein Helge Glad Nordahl¹ 

[1] Norwegian National Advisory Unit on Vestibular Disorders, Department of Otorhinolaryngology & Head Neck Surgery, Haukeland University Hospital;Department of Clinical Medicine, University of Bergen;Research Department, Division of Psychiatry;Department of Otorhinolaryngology & Head and Neck Surgery, Oslo University Hospital

关键词: barbecue;    benign positional vertigo;    horizontal semicircular canal;   

DOI  :  10.1002/lio2.420

学科分类：环境科学（综合）

来源: Wiley

【 摘 要 】

Objectives: To compare the effect of a high-speed barbecue maneuver with the modified Lempert maneuver and sham in patients with benign paroxysmal positional vertigo (BPPV) of the horizontal canal. Methods: Randomized sham-controlled, single blinded multicenter clinical trial in two university hospitals investigating consecutive patients with horizontal canal BPPV. Patients were randomly assigned to high-speed barbecue (HSB), modified Lempert maneuver (ML), or sham maneuver (SM). All treatments were performed in a biaxial rotational chair with weekly follow-up to a maximum of three treatment sessions. The final follow-up was 3 months after the last treatment. Results: Primary outcome: 2-week recovery rate per protocol. Secondary outcome: Cumulative recovery rate and Dizziness Handicap Inventory (DHI) scores after 3 months per protocol (HSB and ML) and intention to treat (all groups). Fifty-four patients were analyzed after 2 weeks (HSB = 17; ML = 20; SM = 17). Twoweek recovery rate was 14/17 after HSB, 11/20 after ML, and 4/17 after SM, with significantly better recovery in HSB [OR 15.17, 95% CI (1.85, 124.63), P = .001] using sham as base level. Recovery rate after 3 months was 15/17 after HSB and 15/19 after ML. Cumulative recovery rate showed no significant differences between the two treatment groups [95% CI (0.30, 13.14), P = .46] in cure rate DHI [95% CI (−16.56, 15.02), P = .92]. No unexpected adverse events were observed. Conclusion: Velocity change in horizontal canal BPPV treatment gives a faster initial recovery. Rapid recovery could reduce the disease burden.

【 授权许可】

CC BY|CC BY-NC-ND