Yetiser Sertac, Salturk Ziya
Department of Otorhinolaryngology Head and Neck surgery , Anadolu Medical Center, Kocaeli 41400, Turkey.
Iran J Otorhinolaryngol. 2021 Nov;33(119):339-346. doi: 10.22038/IJORL.2021.55574.2912.
Benign paroxysmal positional vertigo (BPPV) is a common cause of peripheral vestibular disturbances. Particle repositioning or liberatory maneuvers provide relief of symptoms in the majority of patients. However, studies mainly focus on success. This study aims to review the conditions that may have an impact on residual dizziness or recurrence following therapeutic maneuvers in patients with BPPV.
A review of the literature about the analysis of quality of life after therapeutic maneuvers was conducted. Three hundred and seven articles after search in the PubMed database were classified into eight main groups after exclusion of those that are not suitable to predetermined criteria.
Thirty-eight articles for residual dizziness in BPPV, eighty-three articles for the duration of BPPV, forty articles for the type of canal involvement, forty-three articles for the impact of age, one hundred and nine articles for the gender difference, forty-seven articles for co-morbid conditions, one hundred and twenty-four articles for medication and sixty-eight articles for vestibular exercises in BPPV were selected.
VEMP abnormality is a reliable indicator to demonstrate the risk of recurrence. Duration of dizziness has no significant impact on recurrence. But the length of duration is important for residual dizziness. Vestibular rehabilitation or medication alone has no place in treatment but may help to reduce the symptoms in addition to maneuver. Self-perceived evaluation of balance after therapeutic maneuvers is recommended for the selection of those who need rehabilitation or additional medication.
良性阵发性位置性眩晕(BPPV)是周围性前庭功能障碍的常见病因。耳石复位或解放手法可使大多数患者症状缓解。然而,研究主要关注成功率。本研究旨在回顾可能影响BPPV患者治疗手法后残留头晕或复发的因素。
对治疗手法后生活质量分析的文献进行综述。在PubMed数据库中检索到的307篇文章,经排除不符合预定标准的文章后,分为八个主要类别。
选取了38篇关于BPPV残留头晕的文章、83篇关于BPPV病程的文章、40篇关于受累半规管类型的文章、43篇关于年龄影响的文章、109篇关于性别差异的文章、47篇关于合并症的文章、124篇关于药物治疗的文章以及68篇关于BPPV前庭锻炼的文章。
前庭诱发肌源性电位(VEMP)异常是复发风险的可靠指标。头晕持续时间对复发无显著影响。但持续时间对残留头晕很重要。单纯的前庭康复或药物治疗在治疗中无作用,但除手法治疗外可能有助于减轻症状。建议在治疗手法后进行自我平衡评估,以筛选出需要康复治疗或额外药物治疗的患者。