Combined Epley and Semont Maneuver in Benign Paroxysmal Positional Vertigo

Nevzat Demirbilek*

Combined Epley and Semont Maneuver in Benign Paroxysmal Positional Vertigo.

Benign paroxysmal positional vertigo is defined as a short, episodic, transient vertigo
caused by changes in the position of the head. The most commonly observed reason is peripheral vestibular system disease.

Although benign paroxysmal positional vertigo affects all three semicircular canals, the most commonly involved one is the posterior canal. It is very important to identify which canal is involved in determining the treatment to be administered.

Patients diagnosed with benign paroxysmal positional vertigo are frequently treated with repositioning maneuvers. The most commonly used one, the Epley maneuver is based on the canalithiasis theory, whereas the other commonly used a maneuver, the Semont maneuver is based on the cupulolithiasis theory.

Patients with non-posterior canal or bilateral canal involvement, those using ototoxic and tranquilizing drugs, those who could not tolerate the Dix-Hallpike test, those suspected of having central nervous system  disorders, patients with vestibular system diseases other than BPPV such as Meniere’s disease, postural hypotension, chronic otitis media, perilymph fistula, labyrinthitis and vestibular neuritis were excluded from the

Individuals who were to be tested for VNG were asked not to use any sedative drugs or take alcohol within 48 hours prior to the test. For a healthy recording, any makeup around the eyes was cleaned before the test. A quiet, dimly lit room and a quiet environment were preferred for the test to avoid distracting the patient.

Dynamic positional tests were performed together with VNG. The images were recorded. slowing and disappearance of the nystagmus when the maneuver was repeated and observation of concomitant vertigo with nystagmus, were considered as indicators of posterior canal BPPV. The absence of horizontal canal BPPV after the roll test was also confirmed.

Otolaryngol Open J. 2019; 5(1): 8-12. doi: 10.17140/OTLOJ-5-152