Otolaryngology Department, San Juan de Dios Hospital, University of Chile, Huérfanos, 3255, Santiago, Chile.
Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
Eur Arch Otorhinolaryngol. 2019 Aug;276(8):2191-2198. doi: 10.1007/s00405-019-05460-2. Epub 2019 May 7.
To assess the effectiveness of a variation of the Epley maneuver, which we have titled "Chair-based Abbreviated Repositioning maneuver (ChARM)", in solving cases of benign positional paroxysmal vertigo (BPPV) of the posterior canal. ChARM addresses multiple issues of highly overloaded medical centers that delay its due and timely resolution. For example it does not necessitate an examination bed/table and requires only a backed chair, and less than 3 min to be performed. In combination with a recently published abbreviated diagnostic maneuver it can solve BPPV cases within few minutes of single medical visit.
Patients being diagnosed with posterior BPPV by means of an abbreviated diagnostic maneuver were recruited. Immediately after diagnosis, a single attempt of ChARM was conducted. The patient was followed for 48 h and at 1 month after these procedures to assess the persistence of symptomatology.
124 patients were treated with ChARM immediately after diagnosis during their very first medical visit. 92 patients (74.2%) solved their symptomatology completely after a single attempt of ChARM. The absence of symptoms persisted during the 30 days of follow-up.
ChARM showed high success rates in solving posterior BPPV. The entire diagnostic-treatment procedure takes less than 5 min to perform and may allow direct treatment of patients, thereby avoiding unnecessary referrals or full vestibular testing. These abbreviated tools may be particularly useful in primary care settings or heavily overloaded otolaryngology or neurology departments.
评估我们称之为“椅子式简化复位手法（ChARM）”的 Epley 手法变体在治疗后半规管良性阵发性位置性眩晕（BPPV）中的效果。ChARM 解决了高度超负荷的医疗中心的多个问题，这些问题会延迟其应有的及时解决。例如，它不需要检查床/桌子，只需要一把有靠背的椅子，并且不到 3 分钟即可完成。与最近发表的简化诊断手法相结合，它可以在单次就诊的几分钟内解决 BPPV 病例。
通过简化的诊断手法诊断为后 BPPV 的患者被招募。在诊断后立即进行单次 Charm 尝试。在这些程序后 48 小时和 1 个月对患者进行随访，以评估症状的持续时间。
124 例患者在首次就诊时立即接受 ChARM 治疗。92 例（74.2%）患者在单次 Charm 尝试后完全解决了症状。在 30 天的随访期间，没有症状持续存在。
ChARM 在解决后 BPPV 方面显示出很高的成功率。整个诊断-治疗过程不到 5 分钟即可完成，并且可以直接治疗患者，从而避免不必要的转诊或全面的前庭测试。这些简化工具在初级保健环境或耳鼻喉科或神经内科高度超负荷的情况下可能特别有用。
