A multicenter randomized double-blind study: comparison of the Epley, Semont, and sham maneuvers for the treatment of posterior canal benign paroxysmal positional vertigo.
We evaluated the short-term efficacy of Epley, Semont, and sham maneuvers for resolving posterior canal benign paroxysmal positional vertigo (BPPV) in a prospective multicenter randomized double-blind controlled study. Subjects were randomly divided into three groups: Epley (36 patients), Semont (32 patients), and sham (Epley maneuver for the unaffected side, 31 patients). Out of 14 institutes which participated in this study, 5 institutes had previous experience of the Epley but not the Semont maneuver and the other 9 had previous experience of both maneuvers. Each maneuver was repeated twice if there was still positional vertigo or nystagmus on day 0, and the presence of nystagmus and vertigo on positional testing were evaluated immediately, 1 day, and 1 week after treatment. After the first maneuver, the Epley group showed a significantly higher resolution rate of positional nystagmus than the Semont or sham groups (63.9, 37.5, and 38.7%, respectively). After the second maneuver, the resolution rate (83.3%) of the Epley group was significantly higher than that (51.6%) of the sham group. At 1 day and 1 week after treatment, the resolution rate of the Epley group was significantly higher than those of the other groups. Similar results were seen for the resolution of positional vertigo. The Epley maneuver showed persistent resolution rates of positional vertigo and nystagmus without a fatigue phenomenon. The Epley maneuver was significantly more effective per maneuver than Semont or sham maneuvers for the short-term treatment of posterior canal BPPV. The Semont maneuver showed a higher success rate than the sham maneuver, but it was not significantly different.
Department of Otorhinolaryngology, Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea.
Jong Dae
JD
Lee
Dae Bo
DB
Shim
Hong Ju
HJ
Park
Chan Il
CI
Song
Min-Beom
MB
Kim
Chang-Hee
CH
Kim
Jae Yong
JY
Byun
Sung Kwang
SK
Hong
Tae Su
TS
Kim
Kye Hoon
KH
Park
Jae-Hyun
JH
Seo
Byoung Soo
BS
Shim
Joon Han
JH
Lee
Hyun Woo
HW
Lim
Eun-Ju
EJ
Jeon
D000328:Adult; D000368:Aged; D065635:Benign Paroxysmal Positional Vertigo / Q000150:complications / Q000534:rehabilitation*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000150:complications / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D016896:Treatment Outcome