Therapeutic Effect of Canalith Repositioning Procedures with or without Anti-vertigo Drugs on Benign Paroxysmal Positional Vertigo_West China Medical Journal

Authors：

LIU Jun ,  ZHANG Yi

Department of Otolaryngology Head and Neck Surgery, Renji Hospital, Jiaotong University, Shanghai 200127, P. R. China;

Corresponding author：

ZHANG Yi, Email: liujun1220@hotmail.com

Keywords：

良性阵发性位置性眩晕; 手法复位; 眩晕; 半规管; 眼震

Video：

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目的　比较单纯手法复位和手法复位合并口服抗眩晕药治疗良性阵发性位置性眩晕（BPPV）的短期和长期疗效。方法　将2004年1月－2011年6月期间收治的236例BPPV患者随机分为两组，对照组112例采用单纯手法复位，观察组124例在手法复位基础上配合口服抗眩晕药治疗，两组均于1周和3个月后复查，并随访观察1年，且比较其疗效。结果　观察随访1年后，对照组总治愈率92.86% (104/112），观察组治愈率为93.54%（116/124），两者比较差异无统计学意义。结论　单纯手法复位和手法复位合并口服抗眩晕药治疗BPPV其疗效相当，但可作为BPPV患者的首选治疗方法。
Objective　 To evaluate the short-term and long-term effect of canalith repositioning procedures with or without anti-vertigo drugs on benign paroxysmal positional vertigo (BPPV). Methods 　A total of 236 cases of BPPV that were treated with particle repositioning maneuver with medicine treatment from January 2004 to June 2011. The patients were divided into control group (112 patients, underwent canalith repositioning procedures) and observation group (124 patients, underwent canalith repositioning procedures with medication of anti-vertigo drugs). The two groups were reappraised after one week and three months respectively, and the follow-up duration was one year. Results　 The success rate was 92.86% (104/112) in the control group and 93.55%(116/124) in the observation group one year after the treatment. The difference between the two groups was not significant. Conclusion　 The effect of canalith repositioning procedures with or without anti-vertigo drugs on BPPV does not differ much from each other.

Citation： LIU Jun ,ZHANG Yi. Therapeutic Effect of Canalith Repositioning Procedures with or without Anti-vertigo Drugs on Benign Paroxysmal Positional Vertigo. West China Medical Journal, 2012, 27(1): 70-72. doi: Copy

1.	中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉科学分会．良性阵发性位置性眩晕的诊断依据和疗效评估(2006年.贵阳)[J]. 中华耳鼻咽喉头颈外科杂志, 2007, 42(3): 163-164．.
2.	Epley JM. Particle repositioning for benign paroxysmal positional vertigo[J]. Otolaryngol Clin North Am, 1996, 29(2): 323-331.
3.	Bertholon P, Trinqali S, Faye MB, et al. Prospective study of positional nystagmus in 100 consecutive patients[J]. Ann Otol Rhinol Laryngol 2006, 115(8): 587-594.
4.	Parnes LS, McClure JA. Free-floating endolymph particles:a new operative finding during posterior semicircular canal occlusion[J]. Laryngscope, 1992, 102(9): 988-992.
5.	Welling DB, Parnes LS, O’Brien B, et al．Particulate matter in the posterior semicircular canal[J]. Laryngoscope,1997, 107(1): 90-94.
6.	Schuknecht HF. Cupulolithiasis[J]. Arch Otolaryngol, 1969, 90(6): 765-778.
7.	刘秋玲, 王跃建, 周晓娓, 等. 1240例良性阵发性位置性眩晕患者手法复位治疗[J]. 中华耳科学杂志, 2010, 8(4): 427-430.
8.	郭小艳, 耿曼英, 魏秀芬. Epley法治疗良性阵发性位置性眩晕60例分析[J]. 中国实用神经疾病杂志, 2010, 13(3): 20-21.
9.	Hilton M, Pinder D. The Epley(canalith repositioning) manoeuvre for benign paroxysmal positional vertigo[J]. Cochrane Database Syst Rev, 2004(2): CD003162.
10.	Parne LS, Agrawal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertigo(BPPV)[J]. CMAJ, 2003, 169(7): 681-693.
11.	Neuhauser HK, Lempert T. Vertigo:epidemiologic aspects[J]. Semin Neurol, 2009, 29(5): 473-481.
12.	Inaqaki T, Suzuki M, Otsuka K, et al. Model experiments of BPPV using isolated utricle and posterior semicircular canal[J]. Auris Nasus Larynx, 2006, 33(2): 129-34.
13.	Welling DB, Barnes DE. Particle repositioning maneuver for benign paroxysmal positional vertigo[J]. Laryngoscope, 1994, 104(8Pt1): 946-949.
14.	Bhattacharyya N, Baugh RF, Orvidas L, et al. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo[J]. Otolaryngol Head Neck Surg, 2008, 139 (5 Suppl 4): 47-81.
15.	Fife TD, Iverson DJ, Lempert T, et al. Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology[J]. Neurology, 2008, 70(22): 2067-2074.
16.	Leveque M, Labrousse M, Seidermann L, et al. Surgical therapy in intractable benign paroxysmal positional vertigo[J]. Otolaryngol Head Neck Surg, 2007, 136(5): 693-698.
17.	Aqrawal SK, Parnes LS. Human experience with canal plugging[J]. Ann N Y Acad Sci, 2001, 942: 300-305.
18.	Pournaras I, Kos I, Guyot JP. Benign paroxysmal positional vertigo: a series of eight singular neurectomies[J]. Acta Otolaryngol, 2008, 128(1): 5-8.
19.	Gacek RR. Transection of the posterior ampullary nerve for the relief of benign paroxysmal positional vertigo[J]. Ann Otol Rhinol Laryngol, 1974, 83(5): 596-605.

1. 　中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉科学分会．良性阵发性位置性眩晕的诊断依据和疗效评估(2006年.贵阳)[J]. 中华耳鼻咽喉头颈外科杂志, 2007, 42(3): 163-164．.
2. 　Epley JM. Particle repositioning for benign paroxysmal positional vertigo[J]. Otolaryngol Clin North Am, 1996, 29(2): 323-331.
3. 　Bertholon P, Trinqali S, Faye MB, et al. Prospective study of positional nystagmus in 100 consecutive patients[J]. Ann Otol Rhinol Laryngol 2006, 115(8): 587-594.
4. 　Parnes LS, McClure JA. Free-floating endolymph particles:a new operative finding during posterior semicircular canal occlusion[J]. Laryngscope, 1992, 102(9): 988-992.
5. 　Welling DB, Parnes LS, O’Brien B, et al．Particulate matter in the posterior semicircular canal[J]. Laryngoscope,1997, 107(1): 90-94.
6. 　Schuknecht HF. Cupulolithiasis[J]. Arch Otolaryngol, 1969, 90(6): 765-778.
7. 　刘秋玲, 王跃建, 周晓娓, 等. 1240例良性阵发性位置性眩晕患者手法复位治疗[J]. 中华耳科学杂志, 2010, 8(4): 427-430.
8. 　郭小艳, 耿曼英, 魏秀芬. Epley法治疗良性阵发性位置性眩晕60例分析[J]. 中国实用神经疾病杂志, 2010, 13(3): 20-21.
9. 　Hilton M, Pinder D. The Epley(canalith repositioning) manoeuvre for benign paroxysmal positional vertigo[J]. Cochrane Database Syst Rev, 2004(2): CD003162.
10. 　Parne LS, Agrawal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertigo(BPPV)[J]. CMAJ, 2003, 169(7): 681-693.
11. 　Neuhauser HK, Lempert T. Vertigo:epidemiologic aspects[J]. Semin Neurol, 2009, 29(5): 473-481.
12. 　Inaqaki T, Suzuki M, Otsuka K, et al. Model experiments of BPPV using isolated utricle and posterior semicircular canal[J]. Auris Nasus Larynx, 2006, 33(2): 129-34.
13. 　Welling DB, Barnes DE. Particle repositioning maneuver for benign paroxysmal positional vertigo[J]. Laryngoscope, 1994, 104(8Pt1): 946-949.
14. 　Bhattacharyya N, Baugh RF, Orvidas L, et al. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo[J]. Otolaryngol Head Neck Surg, 2008, 139 (5 Suppl 4): 47-81.
15. 　Fife TD, Iverson DJ, Lempert T, et al. Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology[J]. Neurology, 2008, 70(22): 2067-2074.
16. 　Leveque M, Labrousse M, Seidermann L, et al. Surgical therapy in intractable benign paroxysmal positional vertigo[J]. Otolaryngol Head Neck Surg, 2007, 136(5): 693-698.
17. 　Aqrawal SK, Parnes LS. Human experience with canal plugging[J]. Ann N Y Acad Sci, 2001, 942: 300-305.
18. 　Pournaras I, Kos I, Guyot JP. Benign paroxysmal positional vertigo: a series of eight singular neurectomies[J]. Acta Otolaryngol, 2008, 128(1): 5-8.
19. 　Gacek RR. Transection of the posterior ampullary nerve for the relief of benign paroxysmal positional vertigo[J]. Ann Otol Rhinol Laryngol, 1974, 83(5): 596-605.

West China Medical Journal

Therapeutic Effect of Canalith Repositioning Procedures with or without Anti-vertigo Drugs on Benign Paroxysmal Positional Vertigo

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