Vestibular suppressants after canalith repositioning in benign paroxysmal positional vertigo.
OBJECTIVE
To investigate the characteristics of residual symptoms and to evaluate the effects of adjuvant vestibular suppressants on residual symptoms after successful canalith repositioning procedures (CRPs).


METHODS
Individual randomized controlled trial.


METHODS
One hundred fifty patients with idiopathic benign paroxysmal positional vertigo who achieved successful CRPs on initial visit participated in this study. Dizziness Handicap Inventory (DHI) questionnaires were completed before CRPs. All study populations were divided into three groups after successful CRPs on the initial visit day: the medication (V) group (treated with a vestibular suppressant [dimenhydrinate 50 mg per day]), the placebo (P) group, and the no medication (N) group. One week after successful CRPs, residual symptoms were checked and repeated DHI questionnaires were completed to compare residual symptoms.


RESULTS
Among the 138 patients who did not show positional nystagmus at follow-up, 67 (48.5%) complained of residual symptoms. The presence of residual symptoms was more prevalent in the P and N group compared with the V group (P = .035, P = .017, respectively). The most frequent residual symptom was lightheadedness (n = 42). Moreover, in the V group, lightheadedness was significantly reduced compared with the P group (P = .029). However, in the analysis of DHI, total and subscale scores did not differ across the three groups before or after successful CRP.


CONCLUSIONS
Vestibular suppressants significantly reduced residual symptoms compared to both placebo and no medication after CRP. However, there was no significant reduction in DHI score compared with the control group, suggesting that the residual symptoms could not be evaluated by DHI score alone.
Department of Otolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Min-Beom
MB
Kim
Hyun S
HS
Lee
Jae H
JH
Ban
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000008:administration & dosage; D065635:Benign Paroxysmal Positional Vertigo / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D004111:Dimenhydrinate / Q000008:administration & dosage*; D004244:Dizziness / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009760:Nystagmus, Physiologic / Q000502:physiology*; D013506:Otologic Surgical Procedures; D056888:Patient Positioning; D011183:Postoperative Complications; D012189:Retrospective Studies; D012665:Semicircular Canals / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014724:Vestibular Function Tests; D014722:Vestibule, Labyrinth / Q000187:drug effects* / Q000503:physiopathology; D055815:Young Adult
D000932:Antiemetics; D004111:Dimenhydrinate
Benign paroxysmal positional vertigo; symptom; treatment; vestibular suppressant