Abstract
Objective: To assess the short and long-term efficacy of canalith repositioning procedure (CRP) in the treatment of patients with benign paroxysmal positional vertigo (BPPV).
Method: Nine hundred sixty-five patients (481 men and 484 women, from 18 to 84 years old) were enrolled in this prospective study during 1995-2010. Inclusion criteria were patient history compatible with BPPV and positive provocative maneuver (either Dix-Hallpike or Roll test). Reported duration of symptoms at the time of their first examination varied from 1 day to 18 months. A variant of Epley and Barbeque maneuver was used. The Epley maneuver was used for posterior and anterior canal involvement, and “Barbeque roll” was used for horizontal canal involvement. Short-term follow-up was obtained 48 hours and 7 days after initial treatment, whereas long-term follow-up was obtained at repeated 6 month intervals.
Results: The posterior semicircular canal was involved in 849 (88%) patients treated, whereas the horizontal and anterior semicircular canals were involved in 96 (10%) and 20 (2%) patients, respectively. Symptoms subsided immediately in 819 patients (85%) by the first CRP. Only 19 patients (2%) required CRP more than 3 times. Patients’ mean follow-up was 72 months; symptom recurrence was noted in 135 patients. The great majority of them were elderly patients (n = 33) or had a history of either vestibular neuropathy (n = 27) or head trauma (n = 58).
Conclusion: Our data, based on long-term follow-up, suggest that CRP remains an efficient and long-lasting noninvasive treatment for BPPV.
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