Yetiser Sertac, Ince Dilay
Department of Otorhinolaryngology, Anadolu Medical Center, Kocaeli, Turkey.
Otol Neurotol. 2015 Aug;36(7):1231-7. doi: 10.1097/MAO.0000000000000774.
To compare the diagnostic value of the head-bending test (HBT), lying-down positioning test (LDPT) and patient's report to identify the affected canal in video-nystagmographically (VNG) confirmed patients with lateral canal benign paroxysmal positional vertigo (LC-BPPV).
Case series with chart review.
Head-bending, lying-down positioning and the head-roll maneuver (HRM) under VNG guidance. The data were collected in a referral community hospital.
Seventy-eight patients (32 apogeotropic and 46 geotropic nystagmus) with LC-BPPV who had been recruited between 2009 and 2013 were enrolled in the study.
Patients were tested with the HRM and then were asked about subjectively worse side. Later, they were subjected to HBT when sitting and the LDPT. The results were compared and studied with the 1-way ANOVA and chi-square tests. Statistical significance was set at p < 0.05.
Affected side was identified by HRM in 75% of patients with apogeotropic nystagmus and 95.6% of patients with geotropic nystagmus. Approximately 65.6% of patients with apogeotropic and 52% of patients with geotropic nystagmus had nystagmus during LDPT. However, its comparability with HRM was low. However, treatment plan based on LDPT results alone provided relief of symptoms in additional 12.5% of patients with apogeotropic and in 2.2% of patients with geotropic nystagmus. Approximately 63% of patients with apogeotropic and 56% of patients with geotropic nystagmus were able to tell the worse side. Nystagmus comparable with HRM during HBT was low and not diagnostic.
HRM has the greatest diagnostic value of positioning tests in LC-BPPV in this study. LDPT provides some contribution in the diagnosis of LC-BPPV but much less than HRM. Patients' subjective feeling of vertigo was also a useful test. However, HBT was not as sensitive as other measures in uncertain cases.
比较头部弯曲试验（HBT）、卧位定位试验（LDPT）以及患者报告对视频眼震图（VNG）确诊的水平半规管良性阵发性位置性眩晕（LC - BPPV）患者患侧半规管的诊断价值。
病例系列回顾性研究。
在VNG引导下进行头部弯曲、卧位定位及摇头试验（HRM）。数据收集于一家转诊社区医院。
纳入2009年至2013年间招募的78例LC - BPPV患者（32例背地性眼震和46例向地性眼震）。
对患者进行HRM测试，然后询问其主观上症状更严重的一侧。之后，让患者坐位时进行HBT以及LDPT。结果采用单因素方差分析和卡方检验进行比较研究。统计学显著性设定为p < 0.05。
HRM可确定75%的背地性眼震患者和95.6%的向地性眼震患者的患侧。约65.6%的背地性眼震患者和52%的向地性眼震患者在LDPT期间出现眼震。然而，其与HRM的可比性较低。不过，仅基于LDPT结果制定的治疗方案能使额外12.5%的背地性眼震患者和2.2%的向地性眼震患者症状缓解。约63%的背地性眼震患者和56%的向地性眼震患者能够说出症状更严重的一侧。HBT期间与HRM可比的眼震较少且无诊断价值。
在本研究中，HRM在LC - BPPV的定位试验中具有最大的诊断价值。LDPT对LC - BPPV的诊断有一定贡献，但远小于HRM。患者的主观眩晕感受也是一项有用的测试。然而，在不确定的情况下，HBT不如其他方法敏感。
