Epley法和Semont法治疗后半规管良性阵发性位置性眩晕的疗效比较

目的探讨采用Epley管石复位法和Semont管石解脱法治疗后半规管良性阵发性位置性眩晕的疗效。方法将100例确诊为原发性后半规管良性阵发性位置性眩晕的患者随机分为Epley法组和Semont法组,Epley法组给予Epley管石复位法治疗,Semont法组给予Semont管石解脱法治疗,统计治疗1周后的疗效,并随访6个月。结果 Epley法50例,治愈40例,有效3例,无效7例,6个月后复发6例;Semont法50例,治愈31例,有效13例,无效6例,6个月后复发7例。治愈率:Epley法为80%,Semont法为62%,两组比较差异有统计学意义(χ~2=3.93,P0.05);总有效率:Epley法为86%,Semont法为88%,两组比较差异无统计学意义(χ~2=0.019,P0.05);6个月后复发率:Epley法为12%,Semont法为14%,两组比较差异无统计学意义(χ~2=0.019,P0.05)。结论Epley法治疗后半规管BPPV的短期治愈率明显高于Semont法,Epley法应被视为后半规管BPPV的一线首选治疗方法。     

手法复位治疗良性阵发性位置性眩晕36例

目的 评价体位治疗在良性阵发性位置性眩晕（BPPV）的应用价值。方法 回顾性分析36例原发性或继发性BPPV的临床资料,后半规管BPPV采用改良Epley手法或Semont手法复位,水平半规管采用Barbecue翻滚疗法复位治疗,评价其治疗效果。结果 33例后半规管BPPV患者应用改良Epley手法或Semont手法复位,有效率为93.9%。3例水平半规管BPPV患者采取Barbecue翻滚法复位后症状均明显改善。结论 手法复位治疗良性阵发性位置性眩晕方法简单,疗效可靠,治愈率高。     

不同方法治疗后半规管良性阵发性位置性眩晕疗效分析

目的 探讨分别采用Epley和Semont手法复位治疗后半规管良性阵发性位置性眩晕(PC-BPPV)的治疗效果.方法 将263例PC-BPPV患者随机分为Epley治疗组(133例)与Semont治疗组(130例),分别采用Epley和Semon手法复位治疗,观察治疗效果.结果 263例经手法复位治疗一周后随访总有效率84.8%(223/263),其中Epley治疗组有效率为85.7%(114/133),Semont治疗组有效率为83.8%(109/130),3个月后随访总有效率92.4%(243/263),其中Epley治疗组有效率为91.7%(122/133),Semont治疗组有效率为93.1%(121/130).随访中有21例患者复发,其中Epley组11例,Semon组10例,再次行手法复位治疗,眩晕症状仍可缓解.结论 Epley和Semon手法复位治疗PC-BPPV疗效明显,总体疗效差异无统计学意义.     

李氏复位法治疗良性阵发性位置性眩晕的远期疗效分析

目的探讨良性阵发性位置性眩晕(BPPV)的临床特征,观察李氏复位法治疗BPPV的远期疗效。方法回顾分析2009年7月至2014年4月诊治的258例行李氏手法复位的单半规管BPPV患者的临床特征,并根据受累半规管的情况行李氏手法复位治疗,观察并分析远期疗效。本组资料中,后半规管BPPV72例(27.9%),水平半规管BPPV120例(46.5%),"上半规管"BPPV66例(25.6%)。结果 258例患者随访1周后痊愈196例(76.0%),有效45例(17.4%),无效17例(6.6%),总有效241例(93.4%);随访3月后痊愈209例(81.0%),有效15例(5.8%),无效15例(5.8%),复发19例(7.4%),总有效224例(86.8%)。其中经1次李氏手法复位后痊愈者163例(63.2%),有效80例(31.0%),无效15例(5.8%),1次复位总有效率为94.2%。各种类型半规管BPPV患者之间的远期总有效率无统计学差异。结论应用李氏手法复位法对BPPV患者进行治疗,疗效确切,且不需要判断眼震的有无及方向,操作简洁,过程迅速,可在临床应用。     

改良Semont方法治疗后半规管良性阵发性位置性眩晕的短期疗效研究

目的　研究改良Semont方法治疗后半规管良性阵发性位置性眩晕（posterior semicircular canal benign paroxysmal positional vertigo,PSC-BPPV）的短期疗效。方法　2015年10月～2016年4月在耳鼻咽喉科门诊经Dix-Hallpike试验及Roll试验,确诊为单侧PSC-BPPV管结石症患者93例,应用改良Semont方法治疗,观察复位后3 d和7 d有效率。结果　治疗过程中部分患者出现不同程度眩晕、恶心症状,但所有患者均顺利完成复位治疗。93例应用改良Semont复位法复位,3 d随访,痊愈、有效和无效分别为72、16和5例,治愈率77.4%,总有效率94.6%;1周随访,痊愈、有效和无效分别为84、5和4例,治愈率90.3%,总有效率95.7%。结论　改良Semont复位法治疗PSC-BPPV可靠有效,可以作为治疗PSC-BPPV的有效补充。     

耳石复位法治疗良性阵发性位置性眩晕32例

目的 探讨耳石复位法治疗良性阵发性位置性眩晕（BPPV）的的效果。方法 应用Epley管石复位法、Semont管石解脱法及Barbecue翻滚法对良性阵发性位置性眩晕32例予以治疗。结果 32例中经耳石复位法治愈27例(84.4%)，有效 3例(9.4%)，复位失败2例(6.3%)，后经前庭功能训练治愈。结论 耳石复位法是BPPV的首选治疗方法，对于复位失败的患者前庭功能训练可获得较好的疗效。     

摇头变位试验在后半规管良性阵发性位置性眩晕诊断中的应用

目的 探讨摇头变位试验对后半规管良性阵发性位置性眩晕(PC-BPPV)的诊断价值.方法 对以位置性眩晕为主诉的疑似后半规管良性阵发性位置性眩晕的189例患者,由2位有经验的专科医生重复进行Dix-Hallpike变位试验(DH)、翻转试验,对DH试验阴性者行摇头Dix-Hallpike变位试验(HSDH),并进行Epley复位或者Semont复位治疗.结果 189例患者中,共诊断为PC-BPPV140例(74.07%,140/189),其中,经DH诊断PC-BPPV128例,诊断率为67.72%(128/189);经HSDH诊断PC-BPPV12例,诊断率增加了6.35%(12/189).140例患者经手法复位治疗全部治愈.结论 摇头Dix-Hallpike变位试验能够提高后半规管良性阵发性位置性眩晕的阳性诊断率.     

手法复位治疗良性阵发性位置性眩晕疗效观察

目的 探讨手法复位治疗良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的方法和效果.方法 根据受累半规管的不同,将对64 例明确诊断为BPPV的患者分为两组,后半规管BPPV(PC-BPPV)组61例,行改良Epley 方法治疗,水平半规管BPPV(HC-BPPV)组3例,行改良Semont方法治疗,7~10天后观察治疗效果.结果 61例PC- BBPV患者中,治愈56例(91.8%),有效3例(4.92%),无效2例(3.28%);3例HC-BPPV患者中治愈2例,有效1例.结论 应用Epley法和Semont法手法复位治疗PC-BPPV和HC-BPPV方法简单,安全可靠,疗效肯定.     

不同复位手法治疗后半规管良性阵发性位置性眩晕疗效及原因分析

目的　探讨不同复位手法治疗后半规管良性阵发性位置性眩晕（benign paroxysmal positional vertigo，BPPV）疗效及原因。方法　回顾性分析我院2013年6月 ～2016年12月300例后半规管BPPV患者临床资料，按照患者治疗方法不同分为A组156例，施行Epley复位手法；B组144例，施行Semont管石解脱法。比较两组患者治疗效果、复发率并分析效果不佳的原因。结果　B组患者首次疗效、1周疗效及1个月疗效均明显好于A组（χ2=4.371、5.294及4.542，P 均＜0.05）；Semont管石解脱法治疗管结石症与嵴顶结石症疗效均较好，Epley管石复位法治疗嵴顶结石症疗效较差；两组复发率无明显差异（P＞0.05）。结论　Semont 管石解脱法治疗后半规管BPPV管结石症与嵴顶结石症疗效均较好，Epley管石复位法治疗嵴顶结石症疗效较差。两组BPPV复发率均较高。     

管石解脱法治疗后半规管良性阵发性位置性眩晕

良性阵发性位置性眩晕(benign paroxysmal positional vertigo，BPPV)是因特定头位改变而诱发的阵发性短暂眩晕。后半规管(posterior semicircular canal，PC)发病率最高。2000年2月～2002年6月，我科门诊运用Semont管石解脱法治疗PC-BPPV 38例，报道如下。     

A Chair-based Abbreviated Repositioning Maneuver (ChARM) for fast treatment of posterior BPPV

European Archives of Oto-Rhino-Laryngology - To assess the effectiveness of a variation of the Epley maneuver, which we have titled “Chair-based Abbreviated Repositioning maneuver...     

手法操作在门诊快速诊疗278例良性阵发性位置性眩晕

目的手法操作在门诊快速诊疗良性阵发性位置性眩晕(BPPV)的疗效评估。方法回顾分析2012.1²013.07在我院耳鼻喉门诊就诊的278例典型的良性阵发性位置性眩晕患者,利用手法操作系统诊疗,在门诊治疗后不住院,治疗后1天回访,1次治愈231例,1次治愈率约84%,2-3次复位治愈的47例,占16%,7天回访治愈100%,无一例失访。手法操作治疗效果好。结论手法操作在门诊诊断和治疗良性阵发性位置性眩晕疗效可靠、且简便快速。     

Persistent Direction-Fixed Nystagmus Following Canalith Repositioning Maneuver for Horizontal Canal BPPV: A Case of Canalith Jam

The authors report a 64-year-old man who developed persistent direction fixed nystagmus after a canalith repositioning maneuver for horizontal canal benign paroxysmal positional vertigo (HC-BPPV). The patient was initially diagnosed with right HC-BPPV given that the Dix-Hallpike test showed geotropic horizontal nystagmus that was more pronounced on the right side, although the roll test did not show any positional nystagmus. The patient was treated with a canalith repositioning maneuver (Lempert maneuver). The next day, the patient experienced a different character of dizziness, and left-beating spontaneous nystagmus regardless of head position was observed. After a forced prolonged left decubitus and frequent head shaking, his symptoms and nystagmus resolved. This condition, referred to as canalith jam, can be a complication after the repositioning maneuver in patients with BPPV. Atypical positional tests suggest that abnormal canal anatomy could be the underlying cause of canalith jam.     

Modified Particle Repositioning Procedure

Objectives To evaluate the efficacy of modifications to traditional particle repositioning maneuvers in the treatment of benign paroxysmal positional vertigo. Study Design Prospective trial of 118 patients with cupolocanalithiasis of the posterior canal treated with three different canal‐repositioning techniques. Methods Results were compared with the maneuvers employed and the statistical importance of rotating patients by 360° along their longitudinal axis and head shaking on reaching each single position were evaluated. Results Treatment of patients with our maneuver, which, in comparison with traditional repositioning maneuvers, was modified by breaking the procedure up into seven positions and rotating patients by 360° along their longitudinal axis, gives a higher, but not statistically significant, number of treatment successes (84.5%) than the traditional Parnes maneuver (60%) (P = .154); treatment of a third group of patients with our modified particle repositioning maneuver with the addition of head‐shaking on reaching each single position gives a higher (95.6%), statistically significant number of treatment successes than traditional Parnes maneuver (P = .00011). Conclusions The success rates achieved from modified particle repositioning maneuvers are statistically significant. Onset or persistence of dizziness, which patients frequently complain of after liberatory maneuvers, affects only 5.6% of the patients treated. This low incidence is statistically correlated to head‐shaking.     

乳突振荡对半规管耳石复位疗效的影响

目的 研究在半规管耳石复位(CRP)时使用乳突振荡是否可以提高CRP治疗良性阵发性位置性眩晕(BPPV)的效果。方法 采用随机对照试验，将62名诊断为后半规管BPPV的患者分为实验组和对照组，实验组36人，进行CRP加乳突振荡治疗，对照组26人，单纯进行CRP。结果 治疗1周后，实验组的有效率为94％，对照组有效率为72％，治疗后3—4个月，两组复发率分别为18％和22％。结论 使用乳突振荡可以提高CRP对BPPV的治疗效果，对治疗后复发无影响。     

Repositioning chairs in benign paroxysmal positional vertigo: implications and clinical outcome

The objective was to evaluate the clinical value of repositioning chairs in management of refractory benign paroxysmal positional vertigo (BPPV) and to study how different BPPV subtypes respond to treatment. We performed a retrospective chart review of 150 consecutive cases with refractory vertigo referred to our clinic within a 10-month period. The BPPV patients were managed with classical manual manoeuvres, the Epley Omniax^® rotator (EO) or the TRV chair (TRV). In addition, a comprehensive review of the literature was performed. BPPV was identified in 95 cases. The number of needed treatments for posterior canalolithiasis versus posterior cupulolithiasis, horizontal cupulolithiasis and multi-canal affection was significant (p < 0.01). Thirty-seven (38 %) patients required only one repositioning manoeuvre and the overall symptom relief was 91.7–100 % after 3 treatments. Eleven patients (12 %) experienced relapse within the ½-year follow-up period. Horizontal cupulolithiasis and multi-canal affection constituted the most resilient cases. The literature search identified 9 repositioning chair studies. The EO and the TRV are highly valuable assets in diagnosis and management of BPPV of particularly complex and refractory cases. However, further validation is anticipated through controlled clinical trials.     

A Positional Maneuver for Treatment of Horizontal-Canal Benign Positional Vertigo

Horizontal-canal benign positional vertigo (HC-BPV) is characterized by brief attacks of intense vertigo that are induced by mainly rolling over in bed. Examination shows a burst of purely horizontal nystagmus beating toward the undermost ear when the head is turned from supine to either lateral position. Two patients with typical HC-BPV were treated by a new positional procedure that aims to clear particles from the affected canal. The maneuver starts with the patient in the supine position and consists of three 90-degree head rotations toward the unaffected ear. Both patients had immediate and sustained relief of their attacks. No positional nystagmus could be elicited after the maneuver. The rapid cessation of positional vertigo and nystagmus adds evidence that HC-BPV is caused by dense particles that move within the canal whenever its orientation toward gravity is changed.