突发性聋继发良性阵发性位置性眩晕的临床观察

目的了解继发于突发性聋的良性阵发性位置性眩晕（benign paroxysmal positional vertigo,BPPV）的发病情况并探讨其治疗策略。方法观察眩晕门诊及耳内科病房中心2004年1月-2010年1月收治的210例突发性聋患者（包括伴有眩晕的突发性聋）合并BPPV的发病情况,并与同期183例原发性BPPV相比较。结果本组突发性聋病例并发BPPV为19．0％（40／210）;40例患者均为高频感音神经性聋或平坦型感音神经性聋。本文40例继发于突发性聋的BPPV,出现时间均在突发性聋发病后t周内。继发性BPPV的手法复位效果与原发性BPPV相似,大多数都于1～2次就诊后治愈。结论突发性聋继发的BPPV是临床常见的现象;继发于突聋的BPPV与原发性BPPV都是以后半规管BPPV多见,并与原发性BPPV手法复位的疗效相似。     

继发于突发性聋的良性阵发性位置性眩晕的临床特点

目的:回顾性分析继发于突发性聋的良性阵发性位置性眩晕(BPPV)患者的临床表现和治疗结果,并探讨其可能的发病机制。方法:观察178例突发性聋患者中继发BPPV的发病情况和治疗效果,所有患者均按照中华医学会耳鼻咽喉科学分会制订的诊治标准。结果:①突发性聋患者中有31例继发BPPV,后半规管BPPV26例,水平半规管BPPV 5例;均发生于突发性聋同侧的患耳,左耳16例,右耳15例。②突发性聋至继发BPPV的间隔在1周内27例,1周～1个月3例,1～3个月1例。③所有继发于突发性聋的BPPV均经手法复位治愈。结论:BPPV可继发于突发性聋,其中以后半规管BPPV常见,耳石复位是有效的治疗方法。     

突发性聋伴发良性阵发性位置性眩晕的临床特点及疗效观察

目的　探讨突发性聋伴发良性阵发性位置性眩晕（benign paroxysmal positional vertigo,BPPV）的临床特点,观察其疗效。方法　观察2012年10月～2014年6月耳 鼻咽喉科收治的36例突发性聋伴发BPPV发病情况,并与同期原发性BPPV患者40例及突发性聋不伴眩晕患者40例进行疗效比较。结果　伴发BPPV的36例突发性聋患者,受累半规管均与突发性聋发病侧一致,其中水平半规管BPPV 6例,占16.7%（6/36）;后半规管BPPV 27例,占75.0%（27/36）;混合管BPPV 3例,占8.3%（3/36）。36例患者出现BPPV的时间均在突发性聋发病后数小时至数天（＜10天）发生。突发性聋伴发BPPV组1次治愈率明显低于原发性BPPV组,但两种治疗方法的总治愈率均为100%。不伴眩晕突发性聋组的痊愈率、显效率及有效率均高于伴发BPPV组。结论　伴发于突发性聋的BPPV以后半规管多见,与原发性BPPV经耳石复位治疗后均可取得较好疗效。而不伴眩晕的突发性聋其疗效优于伴发BPPV的突发性聋。     

内耳病变并发良性阵发性位置性眩晕

目的了解继发于几种内耳疾病的良性阵发性位置性眩晕（benign paroxysmal positional vertigo，BPPV）的发病情况，进一步了解BPPV的可能发病机制。方法观察眩晕诊疗中心2004年1月至2006年11月53例前庭神经炎、90例突发性聋（包括伴眩晕的突发性聋）、381例梅尼埃病BPPV等的发病情况，并与同期183例原发性BPPV比较。结果4种内耳疾病后可以出现BPPV，分别是前庭神经炎、突发性聋、梅尼埃病和Bell麻痹。前庭神经炎后出现BPPV为9．4％（5／53）；突发性聋后出现BPPV为38．9％（35／90）；梅尼埃病后出现BPPV为0．3％（1／381）；1例Bell麻痹后出现BPPV。其中外半规管BPPV5例；后半规管37例，其中1例后半规管BPPV在复位过程中出现同侧前半规管BPPV。管结石症39例，外半规管嵴顶结石症3例。内耳病变后出现BPPV在发病后半年内出现者占75．0％（27／36）。继发性BPPV的手法复位效果与原发性BPPV相似，大多都可1、2次就诊后治愈。结论内耳病突发性聋、前庭神经炎和梅尼埃病后可以出现BPPV。这种类型的BPPV主要表现为后半规管管结石，偶见外半规管嵴帽结石。原发性BPPV与内耳病变后出现的BPPV手法复位疗效相似。     

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。     

继发于突发性聋的良性阵发性位置性眩晕的疗效分析

目的:探讨突发性聋继发的良性阵发性位置性眩晕(BPPV)手法复位与原发性BPPV手法复位的疗效差异.方法:将392例BPPV患者分为突发性聋伴BPPV组(64例)和原发性BPPV组(328例),所有患者均经位置试验确诊为BPPV,行手法复位后1周,评估其疗效.结果:突发性聋伴BPPV组患者经手法复位治疗1周后评估,治愈...     

突发性聋并发良性阵发性位置性眩晕的临床分析

目的研究突发性聋并发BPPV(benign paroxysmal positional vertigo,BPPV)的临床特点及预后,探讨其可能发病机制。方法回顾性研究198例突发性聋患者的临床资料,根据有无眩晕、眩晕特点和变位试验结果确诊是否并发BPPV,分析突发性聋并发的BPPV的临床特点及预后,并与同期59例原发性BPPV进行比较。结果 28例全聋型突发性聋并发BPPV,BPPV发病均在突聋后1周内,最常见类型是水平半规管BPPV,其次是后半规管BP-PV,而原发性BPPV最常见类型是后半规管BPPV,其次是水平半规管BPPV;突发性聋并发的BPPV手法复位的治愈率和复发率与原发性BPPV相似。结论突发性聋并发的BPPV最常见类型是水平半规管BPPV,其次是后半规管BPPV;其手法复位的治愈率和复发率与原发性BPPV相似。     

耳石复位法治疗良性阵发性位置性眩晕疗效观察

目的观察耳石复位法治疗良性阵发性位置性眩晕(BPPV)的疗效。方法对100例BPPV患者行耳石复位法治疗,其中后上半规管型患者80例采用Epley复位法治疗,水平半规管型患者20例采用Barbecue翻滚法治疗,治疗2周后复查,观察治疗效果。结果 80例一次性治愈,10例经2～3次治愈,5例改善,5例无效,总有效率为95%(95/100)。结论 Epley法和Barbecue翻滚法治疗BPPV效果好,操作简单,适于推广。     

继发于突发性聋的良性阵发性位置性眩晕的诊治分析

目的回顾性分析继发于突发性聋的良性阵发性位置性眩晕(BPPV)的临床特征与诊治效果。方法回顾性分析2011年1月~2017年1月在我科诊疗的30例继发于突发性聋的良性阵发性位置性眩晕病例资料。结果在30例突发性聋合并BPPV患者中,女19例,男11例;年龄16~83岁,平均52岁;听力曲线呈全聋型、平坦型和中频下降型者分别有23例、5例和2例;BPPV中后半规管BPPV占25例,水平半规管BPPV 4例,多半规管BPPV 1例;突聋与BPPV多发生于同一侧(29例)。手法复位治疗后2周和1个月其总有效率分别为60%和73%。结论突发性聋合并BPPV患者其耳聋多呈全聋型,BPPV多为累及后半规管者,突聋与BPPV多发生于同一侧,通过手法复位治疗多数BPPV可获缓解,但其疗效不及原发性BPPV。     

继发性后半规管良性阵发性位置性眩晕的诊治

目的 探讨继发性良性阵发性位置性眩晕(BPPV)的诊断和治疗。方法研究继发性后半规管BPPV的内耳疾病6例病历资料,诊断依据为病史及Dix-Hallpike试验诱导出现的眼震结果。结果 6例内耳疾病(分别为突发性聋3例, 梅尼埃病2例, 前庭神经元炎1例)伴有后半规管良性阵发性位置性眩晕被确诊,通过Dix-Hallpike试验诱发出垂直扭转型眼震。结论 继发性BPPV临床较少见,常为后半规管受累,通过Dix-Hallpike试验和Epley手法复位可以确诊和治愈。     

Diagnosis and treatment of the short-arm type posterior semicircular canal BPPV

IntroductionThe Epley maneuver is useful for the otoconia to return from the long arm of the posterior semicircular canal into the utricle. To move otoconia out of the posterior semicircular canal short arm and into the utricle, we need different maneuvers.ObjectiveTo diagnose the short-arm type BPPV of the posterior semicircular canal and treat them with bow-and-yaw maneuver.Methods171 cases were diagnosed as BPPV of the posterior semicircular canal based on a positive Dix–Hallpike maneuver. We first attempted to treat patients with the bow-and-yaw maneuver and then performed the Dix–Hallpike maneuver again. If the repeated Dix–Hallpike maneuver gave negative results, we diagnosed the patient with the short-arm type of BPPV of the posterior semicircular canal and considered the patient to have been cured by the bow-and-yaw maneuver; otherwise, probably the long-arm type BPPV of the posterior semicircular canal existed and we treated the patient with the Epley maneuver.ResultsApproximately 40% of the cases were cured by the bow-and-yaw maneuver, giving negative results on repeated Dix–Hallpike maneuvers, and were diagnosed with short-arm lithiasis.ConclusionThe short-arm type posterior semicircular canal BPPV can be diagnosed and treated in a convenient and comfortable manner.     

Particle repositioning maneuver for benign paroxysmal positional vertigo

The recent demonstration of free-floating particles in the endolymph of the posterior semicircular canal in patients with benign paroxysmal positional vertigo (BPPV)¹ has renewed interest in the physiology and treatment of this entity. The particle repositioning maneuver (PRM) relocates the free-floating particles from the posterior semicircular canal back into the utricle, relieving the patient of bothersome, often long-standing vertigo. This report represents a prospective study of 27 consecutive patients seen with a diagnosis of BPPV. Eighty-four percent of the patients treated with the particle repositioning maneuver who had no other associated pathology were cured or significantly improved with this new technique. Two patients who failed conservative management went on to surgical intervention with the posterior semicircular canal occlusion. The authors find the particle repositioning maneuver effective for many patients with benign positional vertigo and recommend it as the first-line treatment modality for BPPV.     

良性阵发性位置性眩晕的临床特征分析

目的分析总结良性阵发性位置性眩晕(BPPV)的临床诊治经验。方法对131例BPPV患者进行详细的病史调查,回顾性分析131例良性阵发性位置性眩晕患者的临床资料,并追踪随访3个月。结果 131例患者中,男51例,女80例,年龄20～82岁,平均47.7岁,其中单侧后半规管BPPV患者75例,单侧水平半规管BPPV39例,单侧水平嵴顶结石BPPV4例,前半规管BPPV1例,混合型BPPV8例,主观性BPPV3例。其中,原发性BPPV103例,继发性BPPV28例。结论 BPPV患者有其自身的临床特征,通过对其临床特征的认识和把握,选择合适的治疗方法,指导临床实践。     

突聋伴发良性阵发性位置性眩晕诊治分析

目的探讨突聋伴发良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的临床特点。方法 24例突聋伴发BPPV的患者均行Dix-hallpike、Roll-test、Side-lying test变位实验确诊,按不同听力分型进行突聋治疗的同时行不同受累半规管的手法复位治疗,并对受累半规管、听力情况、年龄因素进行分析。结果 24例患者年龄主要为40岁以上,其中左侧11例(外半规管6例、后半规管3例、后+外半规管2例),右侧13例(外半规管7例、后半规管3例、后+外半规管3例),双侧发病率无统计学差异(P>0.05);听力曲线类型:全聋17人,平坦型(重度聋)5人,中频型(中重度聋)2人。结论突聋的发病因素同时可导致耳石器功能障碍,双耳发病率无差别,听力损失越重耳石器受累越重。     

难治性良性阵发性位置性眩晕的临床分析

目的 探讨难治性良性阵发性位置性眩晕(BPPV)的临床特点及治疗。 方法 回顾分析2014年8月至2016年1月诊断为难治性BPPV的13例患者的临床资料,分析其病因相关因素、类型、临床特点及治疗效果。 结果 13例难治性BPPV中,头部外伤为最常见因素,离地性水平半规管BPPV为最常见类型。根据病因积极治疗伴随疾病,正确手法复位治疗,联合Brandt-Daroff康复训练,11例治愈,随访1年无复发;2例无效;1例后半规管、1例水平半规管BPPV,至他院行半规管堵塞术手术治疗,术后效果好。 结论 难治性BPPV可能与头部外伤及突发性聋等疾病相关,首先需根据病因积极治疗伴随疾病,同时采用正确的手法复位治疗,并联合康复训练。治疗后大部分患者疗效好,无效者行半规管堵塞术效果好。     

The effect of postural restrictions in the treatment of benign paroxysmal positional vertigo

The treatment of benign paroxysmal positional vertigo (BPPV) consists of a repositioning maneuver in order to remove otoliths from the posterior semicircular canal and subsequent postural restrictions to prevent debris from reentering the canal. However, the extent to which postural restrictions affect the final outcomes of BPPV is still uncertain. The purpose of this study is to determine the effects of postural restrictions in the treatment of BPPV, which is caused by otoliths in the posterior semicircular canal, and to evaluate its usefulness as a therapy. Seventy cases diagnosed as BPPV of the posterior semicircular canal were studied. All patients were treated utilizing the modified Epley maneuver. They were divided into two groups. The first group (group A, 35 patients) was instructed to sleep in a semi-sitting position and to avoid moving their heads forward or backward, whereas no instructions were given to the second group (group B, 35 patients). The information gathered from the patients was analyzed by age of onset, gender, duration of the disease and cure rates or recurrence rates. In group A, the average age was 54.5 years and the mean duration of symptoms was 116.5 days, whereas in group B, these measurements were 54.8 years and 86.7 days. The cure rates were 91.4 and 94.3%, respectively. Symptoms recurred in 12.5% of group A patients, while in group B, there was a 9.1% recurrence rate. Our study did not show any significant difference between the two groups. Postural restriction therapy, practiced after the modified Epley repositioning maneuver, did not have a significant effect on the final outcomes of BPPV. Based on our results, we do not recommend this therapy since there was no significant benefit for the patients who utilized postural restrictions.