Pal'chun V T, Guseva A L, Kryukov A I, Kunel'skaya N L
N.I. Pirogov Russian National Research Medical University of the Ministry of Health of Russia, Moscow, Russia.
Sverzhevsky Research Institute of Clinical Otorhinolaryngology, Moscow, Russia.
Vestn Otorinolaringol. 2020;85(6):6-12. doi: 10.17116/otorino2020850616.
The aim of the study is to evaluate the efficiency of the new repositioning maneuver for patients with horizontal canal cupulolithiasis benign paroxysmal positional vertigo (BPPV) to perform independently at home between doctor's sessions.
28 patients with isolated horizontal canal cupulolithiasis BPPV were enrolled. In all of them treatment with Gufoni maneuver was not successful after first session. They were divided in M«-» group (17 patients), M«-» group (11 patients). M«-» group performed forced prolong prositionig on the side with less dizziness between sessions. M«-» group performed forced prolong prositionig on the side with less dizziness and 3-5 repetitions of new repositioning maneuver 2-3 times a day between sessions. Repositioning maneuver consists of head shaking, then moving to one side-lying position with maintaining it until dizziness stops and resuming the upright sitting position, then without a pause performing head shaking and moving to the other side-lying position with maintaining it until dizziness stops and resuming the upright sitting position. The patients visited doctor once a week. Before treatment and 1 week after treatment dizziness handicap inventory (DHI) was administrated.
After 2 and 3 weeks of treatment more patients in M«-» group than in M«-» group were cured (<0.05). After 4 weeks of treatment the number of recovered patients did not significantly differ in both groups. After 1 week of treatment according to DHI scores in M«-» group there were less patients with mild dizziness and more patients with moderate dizziness than in M«-» group (<0.05).
Recovery from horizontal canal cupulolithisis BPPV could be achieved at an early date with self-performing of new repositioning maneuver. Patient-perceived disability in persisting horizontal canal cupulolithiasis could be less if the new repositioning maneuver is performed.
本研究旨在评估一种新的复位手法对水平半规管嵴顶结石症性良性阵发性位置性眩晕(BPPV)患者在两次就诊期间在家中独立进行操作的有效性。
纳入28例孤立性水平半规管嵴顶结石症性BPPV患者。所有患者在首次治疗后采用Gufoni手法治疗均未成功。将他们分为M«-»组(17例患者)、M«-»组(11例患者)。M«-»组在两次就诊期间在头晕较轻的一侧进行强迫性延长体位。M«-»组在两次就诊期间在头晕较轻的一侧进行强迫性延长体位,并每天进行2 - 3次新复位手法的3 - 5次重复操作。复位手法包括头部摇晃,然后向一侧卧位移动并保持该体位直至头晕停止,再恢复直立坐姿,然后不停顿地进行头部摇晃并向另一侧卧位移动并保持该体位直至头晕停止,再恢复直立坐姿。患者每周就诊一次。在治疗前和治疗1周后进行头晕残障评定量表(DHI)评估。
治疗2周和3周后,M«-»组治愈的患者比M«-»组更多(<0.05)。治疗4周后,两组康复患者数量无显著差异。治疗1周后,根据DHI评分,M«-»组轻度头晕的患者比M«-»组少,中度头晕的患者比M«-»组多(<0.05)。
通过自行进行新的复位手法可早日实现水平半规管嵴顶结石症性BPPV的康复。如果进行新的复位手法,持续性水平半规管嵴顶结石症患者的自我感知残疾可能会减轻。