Risk Factors for Treatment Failure in Benign Paroxysmal Positional Vertigo

Abstract

Background and ObjectivesZZParticular repositioning maneuver (PRM) have been recommended as a treatment of benign paroxysmal positional vertigo (BPPV). Some patients require multiple treatments for remission, although most of the patients are treated at the first trial of single maneuver. The purpose of this study was to evaluate risk factors for the treatment failure in patients with posterior canal BPPV (p-BPPV) and horizontal canal BPPV (h-BPPV). Subjects and MethodZZRetrospective review was performed for the 287 patients diagnosed as BPPV visiting the dizziness clinic between February 2011 and August 2012. The diagnostic criteria for BPPV were met by following the guidelines provided by the American Academy of Otolaryngology-Head and Neck Surgery. Patients were classified into two groups: Group 1 (treatment success) that requires only 1 PRM and Group 2 (treatment failure) that requires more than 2 PRMs. We analyzed the relationship between treatment failure and the clinical characteristics, and studied the etiology of BPPV.ResultsZZThe study included 183 patients with p-BPPV, 54 patients with h-BPPV (geotropic type), and 50 patients with h-BPPV (apogeotropic type). The type of BPPV and average numbers of PRM required for remission were significantly related with treatment failure by statistical analysis (p＜0.05, respectively). Statistically significant correlation was demonstrated between the history of ipsilateral inner ear viral infection (acute vestibular neuritis, sudden sensorineural hearing loss) and treatment failure (p＜0.05). ConclusionZZMultiple PRMs may be required in patients with h-BPPV (apogeotropic type) or with secondary BPPV caused by ipsilateral inner ear viral disease. Clinically, this information may be used to provide helpful information for clinicians performing PRM to treat BPPV.

Comparing the Effects of Epley Maneuver and Cinnarizine on Benign Positional Paroxysmal Vertigo; A Randomized Clinical Trial

“…Kim et al . have reported inner ear disease and hearing loss in the same side as factors related to treatment failure with Epley manuever which is in concordance with our study [ 22 ]. In a similar study Sato et al .…”

Benign Paroxysmal Positional Vertigo with Simultaneous Involvement of Multiple Semicircular Canals

“… 4 , 7) In the previous study by the authors, it was observed that the number of procedures needed to treat p-BPPV (1.7±1.40) was significantly lesser than the number of procedures needed to treat h-BPPV (2.0±1.25), and we can expect that performing the Epley maneuver to treat p-BPPV first would be helpful for achieving quicker recovery when the posterior and horizontal semicircular canals are affected. 15) …”

Hydrodeoxygenation of raw bio-oil towards platform chemicals over FeMoP/zeolite catalysts

“…The composition of the bifunctional catalysts reported in the literature [11] aims to achieve a balanced synergy of the capacity of the metallic and acid functions (i) a high hydrogenation capacity and (ii) a limited advance of gasification reactions and deactivation due to coke formation. Noble metals (Ru, Rh, Pt, Pd) are active at a relatively low temperature and usually lead to highly hydrogenated end products [12][13][14][15][16]. Zhang et al [17] were able to avoid coke formation over a Ru catalyst by using super/sub-critical ethanol as a solvent for the organic fraction of bio-oil, and obtaining a hydrocarbon yield of 23.2 wt%.…”