[Efficacy of the modified Epley maneuver versus modified Semont maneuver for posterior canal benign paroxysmal positional vertigo: a meta-analysis].

OBJECTIVE: To evaluate the efficacy of the modified Epley maneuver Versus modified Semont maneuver for posterior canal benign paroxysmal positional vertigo.

METHODS: The randomized controlled trials (RCT) about modified Epley maneuver Versus modified Semont maneuver for posterior canal benign paroxysmal positional vertigo from January 1985 to July 2013 were searched in CNKI,OVID, PubMed, CBM, EMBASE, WanFang Data, and Cochrane Library. Two reviewers independently screened the literatures, extracted the data, and evaluated the methodological quality. Then meta-analyses were conducted by using RevMan 5.1 software.

RESULTS: A total of six RCTs were included. Among the 453 patients involved, 232 patients were in the modified Epley maneuver group, while the other 221 patients were in the modified Semont maneuver group. The results of meta-analyses showed that the efficacy of the modified Epley maneuve group was superior to that of the modified Semont maneuver group in one-week cure rate[OR = 3.25, 95%CI (2.08, 5.10) , P < 0.01], one-week efficient [OR = 4.72, 95%CI (1.16, 19.15) , P = 0.03], with significant differences. There was no significant difference between the two groups in three-months cure rate [OR = 2.10, 95%CI (0.57, 7.75) , P = 0.27], incidence of adverse reactions [OR = 0.82, 95%CI(0.44, 1.52), P = 0.53] and relapse rate [OR = 0.56, 95%CI (0.20, 1.57) , P = 0.27].

CONCLUSIONS: Based on the current studies, modified Epley maneuver is superior to modified Semont maneuver in quicking relief posterior canal benign paroxysmal positional vertigo symptoms, but the long-term efficacy, recurrence rate and incidence of adverse reactions had no significant difference. For the quality restrictions and possible publication bias of the included studies, more double blind RCTs with high quality are required to further assess the effects.