Haynes David S, Resser John R, Labadie Robert F, Girasole Christopher R, Kovach Bradley T, Scheker Luis E, Walker Donald C
Vanderbilt Bill Wilkerson Center for Otolaryngology and Communicative Sciences, Nashville, Tennessee, USA.
Laryngoscope. 2002 May;112(5):796-801. doi: 10.1097/00005537-200205000-00006.
To evaluate and compare the efficacy of the Semont liberatory maneuver on "objective" benign paroxysmal positional vertigo (BPPV) defined as vertigo with geotropic nystagmus in Dix-Hallpike positioning versus "subjective" BPPV defined as vertigo without nystagmus in Dix-Hallpike positioning.
Retrospective chart review.
One hundred sixty-two patients with positional vertigo during Dix- Hallpike positioning were identified. Patients were evaluated for the presence or absence of nystagmus. All patients underwent the Semont liberatory maneuver. The patient's condition at follow-up was documented at 3 weeks as complete, partial, or failure. Repeated procedures were performed if necessary.
There were 127 cases of objective BPPV and 35 cases of subjective BPPV. Overall, 90% of all patients tested had significant improvement of their vertigo after 1.49 maneuvers on average. Improvement was seen in 91% of patients with objective BPPV after 1.59 maneuvers on average, compared with 86% in subjective BPPV after 1.13 maneuvers on average (chi2 test, not significant [P = .5]). Patients with a history of traumatic origin or cause had an overall success rate of 81% compared with 92% for nontraumatic causes or origins (chi2 test, not significant [P = .1]). Recurrences were seen in 29% of patients after a successful initial maneuver; however, 96% of these patients responded to further maneuvers. Four patients with persistent symptoms after conservative management underwent posterior semicircular canal occlusion with resolution of symptoms.
The Semont liberatory maneuver provides relief of vertigo in patients with positional vertigo, even in patients without objective nystagmus.
评估并比较Semont解脱法对“客观性”良性阵发性位置性眩晕（BPPV）（定义为Dix-Hallpike位试验时出现地向性眼震的眩晕）与“主观性”BPPV（定义为Dix-Hallpike位试验时无眼震的眩晕）的疗效。
回顾性病历审查。
确定162例在Dix-Hallpike位试验时有位置性眩晕的患者。评估患者有无眼震。所有患者均接受Semont解脱法治疗。随访3周时记录患者病情为完全缓解、部分缓解或未缓解。必要时进行重复操作。
有127例客观性BPPV和35例主观性BPPV。总体而言，所有接受测试的患者中，平均经过1.49次操作后，90%的患者眩晕症状有显著改善。客观性BPPV患者中，平均经过1.59次操作后，91%的患者症状改善，而主观性BPPV患者平均经过1.13次操作后，86%的患者症状改善（卡方检验，差异无统计学意义[P = 0.5]）。有创伤性病史或病因的患者总体成功率为81%，而非创伤性病因或病史的患者为92%（卡方检验，差异无统计学意义[P = 0.1]）。初次成功操作后，29%的患者出现复发；然而，这些患者中有96%对进一步操作有反应。4例保守治疗后仍有持续症状的患者接受后半规管阻塞术，症状得以缓解。
Semont解脱法可缓解位置性眩晕患者的眩晕症状，即使是无客观性眼震的患者。
