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Therapeutic Efficacy of the Modified Epley Maneuver With a Pillow Under the Shoulders

Clinical and Experimental Otorhinolaryngology 2020년 13권 4호 p.376 ~ 380
이현진, 전은주, 이동회, 서재현,
소속 상세정보
이현진 ( Lee Hyun-Jin ) - Catholic University College of Medicine Incheon St. Mary’s Hospital Department of Otorhinolaryngology-Head and Neck Surgery
전은주 ( Jeon Eun-Ju ) - Catholic University College of Medicine Incheon St. Mary’s Hospital Department of Otorhinolaryngology-Head and Neck Surgery
이동회 ( Lee Dong-Hee ) - Catholic University College of Medicine Uijeongbu St. Mary’s Hospital Department of Otorhinolaryngology-Head and Neck Surgery
서재현 ( Seo Jae-Hyun ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Otolaryngology-Head and Neck Surgery

Abstract


Objectives: Canalolithiasis of the posterior semicircular canal (PC) is the most common reason for benign paroxysmal positional vertigo (BPPV). If a patient is diagnosed with PC-BPPV through the Dix-Hallpike test, the modified Epley maneuver (mEpley) is used as the gold standard treatment. To reduce the discomfort of the standard mEpley, we proposed placing a pillow under the shoulders during this therapeutic maneuver. The purpose of this study was to determine whether the therapeutic efficacy of the mEpley with a pillow under the shoulders (mEpley-PS) was comparable to that of the standard mEpley.

Methods: A randomized controlled study at three academic referral hospitals was conducted in compliance with the CONSORT statement. Patients who were diagnosed with PC-BPPV through the Dix-Hallpike test were randomly assigned to groups A or B. Patients in groups A and B were treated with the standard mEpley and mEpley-PS, respectively. The resolution of vertigo and nystagmus on the Dix-Hallpike test at a 1-week follow-up after treatment was the main outcome measurement to assess the efficacy of treatment.

Results: Forty-one patients diagnosed with PC-BPPV were enrolled in this study. Twenty-one patients were assigned to group A and 20 were assigned to group B. The success rate at 1 week after treatment was 85.7% in group A and 80.0% in group B. There was no statistically significant difference between the two groups (P=0.697).

Conclusion: The therapeutic efficacy of the mEpley-PS was comparable to that of the standard mEpley. The use of the pillow modification may be an excellent alternative if a patient cannot tolerate the head-hanging position, and it is helpful for patients who have anxiety about the head-hanging position. The mEpley-PS can be performed on a bed with or without a headboard. It is both a patient-friendly and a clinician-friendly maneuver.

키워드

Benign Paroxysmal Positional Vertigo; Semicircular Canals; Epley Maneuver

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