Celis-Aguilar Erika Maria, Medina-Cabrera Cindy Anahí, Torrontegui-Zazueta Luis Alejandro, Núñez-Millán Blanca Xóchitl, Castro-Bórquez Karla Mariana, Obeso-Pereda Alejandra, García-Valle César Guillermo, Ochoa-Miranda Carlos Andrey
Otolaryngology and Neurotology Department, Center of Research and Teaching in Health Sciences (CIDOCS), Civil Hospital of Culiacan, Autonomous University of Sinaloa, Eustaquio Buelna # 91, Zip Code 80030 Culiacán, Sinaloa Mexico.
Resident of Otolaryngology Department, Center of Research and Teaching in Health Sciences, Civil Hospital of Culiacan, Autonomous University of Sinaloa, Culiacán, Mexico.
Indian J Otolaryngol Head Neck Surg. 2022 Aug;74(Suppl 1):545-549. doi: 10.1007/s12070-020-02320-y. Epub 2021 Jan 20.
Subjective Benign Paroxysmal Positional Vertigo (S-BPPV) is an atypical form of BPPV, its treatment is not well characterized and is not well known among otolaryngologists. The main aim of this study was to estimate the short-term efficacy of Epley maneuver as treatment for S-BPPV. This was a prospective study in a secondary care center. We included patients with unilateral S-BPPV demonstrated by negative nystagmus on Dix-Hallpike Maneuver (DHM) but with unilateral vestibular symptoms (dizziness or vertigo). Epley maneuver to the affected side was performed. Patients underwent Dizziness Handicap Inventory (DHI) and at 1-week follow-up, DHI and DHM were repeated. Outcome measures were resolution of symptoms during DHM and improvement of DHI scores. Patients were divided into resolved and unresolved groups according to the absence or presence of symptoms during the 1 week DHM. Wilcoxon-Mann-Whitney and Kruskal-Wallis tests were used, quantitative values were reported as mean and standard deviation. The results included thirteen participants, 12 females and 1 male, mean age 53.31 years (SD ± 15.71). Right ear was involved in 46.15% and left in 53.84%. A total of 46.15% patients (n = 6) had resolution of symptoms. DHI initial score for the resolved group was 34.66 ± 22 and for the unresolved group was 39.71 ± 19.61 (= 0.568). At 1-week evaluation scores were 19.66 ± 25.05 for the resolved group and 30.28 ± 21.42 for the unresolved group (= 0.252). DHI improvement was 15.00 ± 23.21 and 9.42 ± 10.17 for each group, respectively (= 0.943). We concluded the Epley maneuver is an effective short-term treatment for S-BPPV. Half of the patients would need further diagnostic tests.
主观性良性阵发性位置性眩晕（S-BPPV）是良性阵发性位置性眩晕（BPPV）的一种非典型形式，其治疗方法尚未得到充分描述，且在耳鼻喉科医生中也不太为人所知。本研究的主要目的是评估Epley手法治疗S-BPPV的短期疗效。这是一项在二级医疗中心进行的前瞻性研究。我们纳入了在Dix-Hallpike试验（DHM）中眼震阴性但有单侧前庭症状（头晕或眩晕）的单侧S-BPPV患者。对患侧进行Epley手法治疗。患者接受眩晕 handicap 量表（DHI）评估，在1周随访时，重复进行DHI和DHM评估。观察指标为DHM期间症状的缓解情况和DHI评分的改善情况。根据1周DHM期间症状的有无，将患者分为症状缓解组和未缓解组。采用Wilcoxon-Mann-Whitney检验和Kruskal-Wallis检验，定量值以均值和标准差表示。结果纳入了13名参与者，12名女性和1名男性，平均年龄53.31岁（标准差±15.71）。右耳受累占46.15%，左耳受累占53.84%。共有46.15%的患者（n = 6）症状得到缓解。症状缓解组的DHI初始评分为34.66±22，未缓解组为39.71±19.61（P = 0.568）。在1周评估时，症状缓解组的评分为19.66±25.05，未缓解组为30.28±21.42（P = 0.252）。每组的DHI改善分别为15.00±23.21和9.42±10.17（P = 0.943）。我们得出结论，Epley手法是治疗S-BPPV的一种有效的短期治疗方法。一半的患者需要进一步的诊断检查。
