Häusler R, Pampurik J
Clinique et Policlinique d'Oto-rhino-laryngologie, Hôpital Cantonal Universitaire, Genève.
Laryngorhinootologie. 1989 Jun;68(6):349-54. doi: 10.1055/s-2007-998351.
Two treatments for the benign paroxysmal positional vertigo are presented and evaluated in this article. The first type of treatment is the surgical section of the posterior ampullary nerve according to Gacek and the second is physiotherapeutic by the manoeuvre of Semont. The section of the posterior ampullary nerve has been realised between 1980 and 1986 on 5 patients suffering from persistent and disabling positional vertigo. All 5 patients were relieved from their vertigo immediately after the operation. One patient developed a post-operative hearing loss. The physiotherapeutic manoeuvre of Semont, which has been developed in order to liberate otolithic deposits from the cupula of the posterior semi-circular canal is applied in our clinic since 1985 as treatment of the benign paroxysmal positional vertigo. The efficiency of the manoeuvre was tested at first in a retrospective study on 50 patients. A single manoeuvre cured 20 of these patients and 15 others were cured after a second manoeuvre. Then, a controlled and prospective study was performed: the clinical course of 40 patients without treatment was compared with 37 patients treated with Semont's manoeuvre. In the group of patients without treatment, only 17 were spontaneously cured from their positional vertigo after 18 days of evolution. In the group treated by Semont's manoeuvre 19 patients were completely healed from vertigo and 16 others were greatly improved. On the basis of these favourable results the authors recommend to treat all cases of paroxysmal positional vertigo at first with Semont's manoeuvre. The section of the posterior ampullary nerve should be restricted to the rare cases with persistent and disabling vertigo.(ABSTRACT TRUNCATED AT 250 WORDS)
本文介绍并评估了两种治疗良性阵发性位置性眩晕的方法。第一种治疗方法是根据加塞克（Gacek）的方法进行后半规管壶腹神经切断术，第二种是采用塞蒙特（Semont）手法进行物理治疗。1980年至1986年期间，对5例患有持续性和致残性位置性眩晕的患者实施了后半规管壶腹神经切断术。所有5例患者术后眩晕立即缓解。1例患者术后出现听力损失。塞蒙特手法是为了将耳石沉积物从后半规管壶腹嵴上解脱出来而研发的，自1985年起在我们诊所用于治疗良性阵发性位置性眩晕。该手法的有效性首先在一项对50例患者的回顾性研究中进行了测试。单次手法治疗使其中20例患者治愈，另外15例患者在第二次手法治疗后治愈。然后，进行了一项对照前瞻性研究：将40例未接受治疗的患者的临床病程与37例接受塞蒙特手法治疗的患者进行比较。在未接受治疗的患者组中，经过18天的病程，只有17例患者的位置性眩晕自发缓解。在接受塞蒙特手法治疗的患者组中，19例患者眩晕完全治愈，另外16例患者有明显改善。基于这些良好结果，作者建议首先用塞蒙特手法治疗所有阵发性位置性眩晕病例。后半规管壶腹神经切断术应仅限于极少数持续性和致残性眩晕的病例。（摘要截选至第250个单词）
