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.
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark. westniels@gmail.com.
Niels
N
West
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
Søren
S
Hansen
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
Martin Nue
MN
Møller
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
Sune Land
SL
Bloch
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
Mads
M
Klokker
D065635:Benign Paroxysmal Positional Vertigo / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning / Q000295:instrumentation / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies
Biaxial chair; Epley Omniax chair; Repositioning manoeuvres; TRV chair; Treatment; Vertigo