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Treatment of Benign Positional Vertigo Using the Semont Maneuver: Efficacy in Patients Presenting Without Nystagmus
Author(s) -
Haynes David S.,
Resser John R.,
Labadie Robert F.,
Girasole Christopher R.,
Kovach Bradley T.,
Scheker Luis E.,
Walker Donald C.
Publication year - 2002
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200205000-00006
Subject(s) - medicine , vertigo , nystagmus , benign paroxysmal positional vertigo , posterior semicircular canal , surgery , audiology
Objective To evaluate and compare the efficacy of the Semont liberatory maneuver on “objective” benign paroxysmal positional vertigo (BPPV) defined as vertigo with geotropic nystagmus in Dix‐Hallpike positioning versus “subjective” BPPV defined as vertigo without nystagmus in Dix‐Hallpike positioning. Study Design Retrospective chart review. Methods One hundred sixty‐two patients with positional vertigo during Dix‐ Hallpike positioning were identified. Patients were evaluated for the presence or absence of nystagmus. All patients underwent the Semont liberatory maneuver. The patient's condition at follow‐up was documented at 3 weeks as complete, partial, or failure. Repeated procedures were performed if necessary. Results There were 127 cases of objective BPPV and 35 cases of subjective BPPV. Overall, 90% of all patients tested had significant improvement of their vertigo after 1.49 maneuvers on average. Improvement was seen in 91% of patients with objective BPPV after 1.59 maneuvers on average, compared with 86% in subjective BPPV after 1.13 maneuvers on average (χ 2 test, not significant [ P = .5]). Patients with a history of traumatic origin or cause had an overall success rate of 81% compared with 92% for nontraumatic causes or origins (χ 2 test, not significant [ P = .1]). Recurrences were seen in 29% of patients after a successful initial maneuver; however, 96% of these patients responded to further maneuvers. Four patients with persistent symptoms after conservative management underwent posterior semicircular canal occlusion with resolution of symptoms. Conclusion The Semont liberatory maneuver provides relief of vertigo in patients with positional vertigo, even in patients without objective nystagmus.