[Comparison of three types of self-treatments for posterior canal benign paroxysmal positional vertigo: modified Epley maneuver, modified Semont maneuver and Brandt-Daroff maneuver]

Yan-xing Zhang, Cheng-long Wu, Gui-rong Xiao, Fang-fang Zhong
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2012, 47 (10): 799-803

OBJECTIVE: To compare the efficacy and recurrence rates of modified Epley maneuver, modified Semont maneuver and Brandt-Daroff maneuver in patients with posterior canal benign paroxysmal positional vertigo (PC-BPPV).

METHODS: One hundred and sixty-eight patients with unilateral PC-BPPV were included in the study, which were divided into four groups randomly, 45 with modified Epley maneuver (group 1), 43 with modified Semont maneuver (group 2), and 40 with Brandt-Daroff maneuver (group 3). There were 40 controls without physical therapy technique (group 4) included. The efficacy after one week and one month, the time to recovery, the frequency of side effects and recurrence rates among the four groups were evaluated.

RESULTS: The efficacy of modified Epley maneuver was superior to the other three groups after one week (χ(2)(1, 2) = 8.55, P < 0.05; χ(2)(1, 3) = 23.23, P < 0.01;χ(2)(1, 4) = 44.00, P < 0.01) and to the Brandt-Daroff maneuver at follow-up evaluation after one month (χ(2) = 8.42, P < 0.05). The efficacy of modified Semont maneuver was superior to the control groups after one week (χ(2) = 14.49, P < 0.01), but there was no difference between the two groups after one month (χ(2) = 0.01, P > 0.05). The efficacy of Brandt-Daroff maneuver was not different with the control group at one week and one month follow-up evaluation (χ(2) = 3.35, P > 0.05;χ(2) = 0.18, P > 0.05). Kaplan-Meier testing showed that the time to recovery was significantly shorter in the modified Epley group. The frequency of side effects was not significantly different among the three physical therapy groups. There was no difference in the frequency of recurrence among the four groups (χ(2) = 4.076, P = 0.253). Duration of illness before self-treatment and age were the independent predictors of recurrence.

CONCLUSIONS: The modified Epley maneuver is more effective for self treatment of PC-BPPV than modified Semont maneuver and Brandt-Daroff maneuver. Daily routine of self-treatment does not prevent the recurrence of PC-BPPV.

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