Efficacy of computer-controlled repositioning procedure for benign paroxysmal positional vertigo

Shan, Xizheng; Peng, Xin; Wang, Entong

doi:10.1002/lary.24961

Cited by 18 publications

(11 citation statements)

References 38 publications

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“…A mobile device application and a head-mounted mechanic device could be used to facilitate self-administration of CRPs [35,36]. Computer-controlled repositioning is also now available [37].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment choices of suspected benign paroxysmal positional vertigo: current approach of general practitioners, neurologists, and ENT physicians

Ulytė

Valančius

Masiliūnas

et al. 2019

Eur Arch Otorhinolaryngol

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PURPOSE: Benign paroxysmal positional vertigo (BPPV) is a frequently underdiagnosed cause of vertigo, potentially due to the underuse of diagnostic and therapeutic canalith repositioning procedures (CRPs). We aimed to investigate self-reported use of the diagnostic and therapeutic approach to BPPV patients by Lithuanian neurologists, ear, nose, and throat (ENT) physicians, and general practitioners (GPs), and to explore potential reasons for the underuse of the maneuvers. METHODS: Neurologists, ENT physicians, and GPs were invited to complete a written questionnaire focused on diagnostic and therapeutic practices related to BPPV. Between-group differences and associations between responses were analyzed statistically. RESULTS: In total, 97 neurologists, 85 ENT physicians and 142 GPs (21.1%, 26.8%, and 5.7%, respectively, of all corresponding licensed Lithuanian physicians) completed the questionnaire. 24% of neurologists, 33% ENT physicians and 50% GPs do not perform diagnostic maneuvers for patients with suspected BPPV, and 28%, 61%, and 84%, respectively, do not perform CRPs. Years of clinical experience was a negative predictor of CRP performance [OR 0.97 (95% CI 0.95-0.99), p = 0.001]. Frequent reasons for not performing CRPs were time taken for the procedure, fear of provoking symptoms, and lack of knowledge. All physicians frequently ordered additional imaging or consultations for suspected BPPV and reported prescribing a range of medications. CONCLUSIONS: A significant proportion of Lithuanian neurologists, ENT physicians, and GPs do not employ diagnostic maneuvers and CRPs for BPPV patients, contrary to established guidelines. Lack of expertise and time available is a common culprit that leads to unnecessary drug prescribing and investigation. (2019). Diagnosis and treatment choices of suspected benign paroxysmal positional vertigo: current approach of general practitioners, neurologists, and ENT physicians. European Archives of Oto-Rhino-Laryngology, 276(4):985-991. Funding:The study received no funding. Conflict of Interest:The authors declare that they have no conflict of interests.Diagnosis and treatment choices of suspected benign paroxysmal positional vertigo: current approach of general practitioners, neurologists and ENT physicians Abstract Purpose Benign paroxysmal positional vertigo (BPPV) is a frequently underdiagnosed cause of vertigo, potentially due to the underuse of diagnostic and therapeutic canalith repositioning procedures (CRPs). We aimed to investigate self-reported use of the diagnostic and therapeutic approach to BPPV patients by Lithuanian neurologists, ENT (ear, nose and throat) physicians, and GPs (general practitioners), and to explore potential reasons for the underuse of the maneuvers. MethodsNeurologists, ENT physicians, and GPs were invited to complete a written questionnaire focused on diagnostic and therapeutic practices related to BPPV. Between-group differences and associations between responses were analyzed statistically. ResultsIn total, 97 neurologists, 85 ENT physic...

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Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment choices of suspected benign paroxysmal positional vertigo: current approach of general practitioners, neurologists, and ENT physicians

Ulytė

Valančius

Masiliūnas

et al. 2019

Eur Arch Otorhinolaryngol

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“…The DHT is the gold standard maneuver for diagnosing psc-BPPV, and the Epley technique is considered a classic method for psc-BPPV reset (16). The DHT and CRP were performed in a diagnosis and treatment system for BPPV (Byron's Medical Science & Technique Inc., Jinan, China) as previously described (17). Using a computer-controlled CRP (CCRP), which still mimics Epley maneuver (EM) (18) parameters in the computer-setting instrument for the treatment of psc-BPPV, avoids the limitations of EM in some elderly patients with physical motor impairment or obesity.…”

Section: Detailed Dht and Crp For Psc-bppvmentioning

confidence: 99%

Association between Dix-Hallpike test parameters and successful repositioning maneuver in posterior semicircular canal benign paroxysmal positional vertigo: a case-control study

Meng

et al. 2020

Ann Transl Med

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Background: Nystagmus (i.e., involuntary eye movement) provoked by the Dix-Hallpike test (DHT) is considered the gold standard for diagnosing posterior semicircular canal benign paroxysmal positional vertigo (psc-BPPV). However, robust evidence regarding this diagnostic maneuver's treatment efficacy is still lacking. This study aimed to investigate the parameters of positional nystagmus in the DHT as prognostic factors for unilateral psc-BPPV. Methods:We reviewed 357 patients with unilateral psc-BPPV who underwent the computer-controlled canalith repositioning procedure (CCRP), which mimics the Epley maneuver. Additionally, positional nystagmus in the DHT was observed through a video-oculography. Patients were retrospectively divided into two groups according to resistance to the CCRP. Univariable and multivariable analyses were performed on age, gender, blood pressure, and nystagmus parameters of the affected side in the DHT in order to reveal associated factors causing resistance to the CCRP.Results: With univariate and multivariate analysis, we observed a decrease in vertical time course during slow phase nystagmus on the affected side (odds ratio, OR 0.77, P=0.011 vs. OR 0.80, P=0.027). Moreover, an increased vertical velocity amplitude in the DHT during slow phase nystagmus (OR 3.16, P=0.029 vs. OR 2.96, P=0.035) remained an associated factor of maneuver resistance.Conclusions: Decreased canalith weight on the affected side was associated with resistance to the CCRP. This association corresponded to the observation that psc-BPPV patients with a decreased time course and increased velocity in the slow phase of recording nystagmus have a worse prognosis of their BPPV persisting after a single CCRP.

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“…The patient was diagnosed as having right posterior canal BPPV and then treated with the device-assisted Epley maneuver as described elsewhere. 10 The performance of the diagnostic or repositioning maneuver was reproduced by the diagnosis and therapy system for BPPV (Byrons Medical Science & Technique Inc., Jinan, China). Next day, the patient still complained of repeated episodic vertigo, but the vertigo attacks occurred when rolling over in bed rather than lying down, therefore the patient was re-evaluated.…”

Section: Casementioning

confidence: 99%

“…The right horizontal canal BPPV was diagnosed, suggesting this was due to canal conversion from the posterior canal to the horizontal canal after the initial Epley maneuver. 2,10 Then, the patient was treated with a device-assisted and modified Lempert maneuver as described elsewhere, 11 and 5 days later, the patient received a repeated maneuver due to his remaining vertigo and persistent positive for the roll test. After this, the patient's symptoms resolved completely, with negative results in subsequent diagnostic tests.…”

Section: Casementioning

confidence: 99%

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Benign paroxysmal positional vertigo secondary to laparoscopic surgery

Shan

Wang

2017

SAGE Open Medical Case Reports

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Objectives:Benign paroxysmal positional vertigo is a common vestibular disorder and it may be idiopathic or secondary to some conditions such as surgery, but rare following laparoscopic surgery.Methods:We report two cases of benign paroxysmal positional vertigo secondary to laparoscopic surgery, one after laparoscopic cholecystectomy in a 51-year-old man and another following laparoscopic hysterectomy in a 60-year-old woman.Results:Both patients were treated successfully with manual or device-assisted canalith repositioning maneuvers, with no recurrence on the follow-up of 6 -18 months.Conclusions:Benign paroxysmal positional vertigo is a rare but possible complication of laparoscopic surgery. Both manual and device-assisted repositioning maneuvers are effective treatments for this condition, with good efficacy and prognosis.

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Efficacy of computer-controlled repositioning procedure for benign paroxysmal positional vertigo

Abstract: Computer-controlled CRP is effective for the treatment of posterior canal BPPV, with a success rate similar to those treated with the Epley maneuver, and is safe and easy to perform on patients.

Cited by 18 publications

References 38 publications

Diagnosis and treatment choices of suspected benign paroxysmal positional vertigo: current approach of general practitioners, neurologists, and ENT physicians

Diagnosis and treatment choices of suspected benign paroxysmal positional vertigo: current approach of general practitioners, neurologists, and ENT physicians

Association between Dix-Hallpike test parameters and successful repositioning maneuver in posterior semicircular canal benign paroxysmal positional vertigo: a case-control study

Benign paroxysmal positional vertigo secondary to laparoscopic surgery

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