Gupta Ashok Kumar, Sharma Kumar Gourav, Sharma Pritosh
Department of ENT, Geetanjali Medical College and Hospital, Manwa Khera, Udaipur, Rajasthan 313002 India.
Indian J Otolaryngol Head Neck Surg. 2019 Mar;71(1):99-103. doi: 10.1007/s12070-018-1322-7. Epub 2018 Mar 30.
Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause in patients with vertigo (Pereira et al. in Braz J Otorhinolaryngol (Impr) 76(6):704-708, 2010; Dix and Hallpike in Ann Otol Rhinol Laryngol 6:987-1016, 1952). Posterior Semicircular Canal BPPV (PSCBPPV) has more incidence and prevalence then Lateral, and Anterior Semicircular Canal BPPV (Alghwiri et al. in Arch Phys Med Rehabil 93:1822-1831, 2012). Quality of life (QoL) is significantly impaired by vertigo (Sargent et al. in Otol Neurotol 22:205-209, 2001; World Health Organization in International classification of functioning, disability and health, World Health Organization, Geneva, 2001). To study the effect and compare Epley, Semont maneuvers and Brandt-Daroff Exercise on QoL in patients with PSCBPPV. 90 individuals with unilateral PSCBPPV were selected based on positive Dix-Hallpike test. 3 groups Epley, Semont, and Brandt-Daroff were formed and 30 individuals were selected in each group randomly. Dix-Hallpike test and Vestibular Activities and Participation (VAP) Scale based on International Classification of Functioning were administered before and after Epley, Semont maneuvers, and Brandt-Daroff Exercise to fulfill the aim. VAP Scale results revealed significant difference between pre and post treatment score in all 3 groups, suggestive of positive effect on QoL in patients with PSCBPPV. Improvements in VAP Score between 3 groups were compared and significant difference was observed. Dix-Hallpike test results revealed that 90, 73.33, and 50% patients improved in Epely, Semont, and Brandt-Daroff group respectively. Epely maneuver found to be the best choice and then Semont and Brandt-Daroff should be least preferred in treatment of patients with PSCBPPV.
良性阵发性位置性眩晕(BPPV)是眩晕患者最常见的病因(佩雷拉等人,《巴西耳鼻喉科杂志》(印刷版)76(6):704 - 708,2010年;迪克斯和霍尔派克,《耳鼻喉科与鼻咽喉科年鉴》6:987 - 1016,1952年)。后半规管BPPV(PSCBPPV)的发病率和患病率高于水平半规管和前半规管BPPV(阿尔赫维里等人,《物理医学与康复档案》93:1822 - 1831,2012年)。眩晕会显著损害生活质量(萨金特等人,《耳鼻喉科与神经耳科学》22:205 - 209,2001年;世界卫生组织,《功能、残疾与健康国际分类》,世界卫生组织,日内瓦,2001年)。为研究Epley法、Semont法和Brandt - Daroff训练对PSCBPPV患者生活质量的影响并进行比较。基于Dix - Hallpike试验阳性选择90例单侧PSCBPPV患者。将其分为Epley组、Semont组和Brandt - Daroff组,每组随机选取30例患者。在进行Epley法、Semont法和Brandt - Daroff训练前后,进行Dix - Hallpike试验以及基于国际功能分类的前庭活动与参与(VAP)量表评估以实现研究目的。VAP量表结果显示,所有3组治疗前后的评分存在显著差异,提示对PSCBPPV患者的生活质量有积极影响。比较了3组之间VAP评分的改善情况,观察到显著差异。Dix - Hallpike试验结果显示,Epley组、Semont组和Brandt - Daroff组分别有90%、73.33%和50%的患者症状改善。发现Epley法是最佳选择,而Semont法和Brandt - Daroff训练在治疗PSCBPPV患者时应是最不首选的方法。