Zhang Hao, Zhu Meijia
Department of Neurology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong, China.
Department of Neurology, The People's Hospital of Rizhao City, Rizhao, Shandong, China.
Front Neurol. 2023 Aug 7;14:1226138. doi: 10.3389/fneur.2023.1226138. eCollection 2023.
This retrospective study aimed to assess the effectiveness and adverse effects of mechanical rotational chair-assisted multiple canalith repositioning procedures (CRPs) to treat benign paroxysmal positional vertigo (BPPV).
A retrospective analysis of 1,273 BPPV patients was conducted, with 241 patients included in the final study. The participants diagnosed with BPPV, unresolved by a single previous CRP, were categorized into either the single or multiple CRP groups. In both groups, on days 1, 4, and 7 after the initial treatment, the participants were re-evaluated after a single CRP; if positional vertigo was resolved, the treatment was regarded as successful. The remission rate, adverse effects (such as canal switch (CS), falls, and vomiting), residual dizziness (RD) rate, and RD duration were compared between the two groups.
The resolution rates for the single and multiple CRP groups were significantly different on days 1 and 4 (55.7% vs. 85.1%, 75.5% vs. 91.9%; < 0.05) but not on day 7 (93.3% vs. 94.8%; > 0.05). There were no significant differences between the single and multiple CRP groups in terms of CS and falls (3.8% vs. 5.2%, 10.3% vs. 8.9%; > 0.05). However, there was a significant difference in the incidence of vomiting (6.6% vs. 14.8%; < 0.05). RD such as head heaviness, imbalance, and non-specific dizziness is more common in the single CRP group than in the multiple CRP group (34.9% vs. 20.7%, 42.5% vs. 26.7%, 47.2% vs. 32.6%; < 0.05). The incidence and duration of RD were notably diminished in the group undergoing multiple CRPs compared to the single CRP group, with incidence rates of 41.5% and 57.5%, respectively ( < 0.05).
For patients with BPPV, multiple CRPs offer greater benefits than a single CRP.
本回顾性研究旨在评估机械旋转椅辅助多管石复位程序（CRPs）治疗良性阵发性位置性眩晕（BPPV）的有效性和不良反应。
对1273例BPPV患者进行回顾性分析，最终纳入研究的患者有241例。将之前单次CRP治疗未治愈的BPPV患者分为单次CRP组或多次CRP组。在两组中，初始治疗后第1、4和7天，患者在单次CRP治疗后进行重新评估；如果位置性眩晕得到缓解，则视为治疗成功。比较两组的缓解率、不良反应（如半规管转换（CS）、跌倒和呕吐）、残余头晕（RD）率及RD持续时间。
单次CRP组和多次CRP组在第1天和第4天的缓解率有显著差异（55.7%对85.1%，75.5%对91.9%；P<0.05），但在第7天无显著差异（93.3%对94.8%；P>0.05）。单次CRP组和多次CRP组在CS和跌倒方面无显著差异（3.8%对5.2%，10.3%对8.9%；P>0.05）。然而，呕吐发生率有显著差异（6.6%对14.8%；P<0.05）。单次CRP组中如头部沉重、失衡和非特异性头晕等RD比多次CRP组更常见（34.9%对20.7%，42.5%对26.7%，47.2%对32.6%；P<0.05）。与单次CRP组相比，多次CRP组的RD发生率和持续时间明显降低，发生率分别为41.5%和57.5%（P<0.05）。
对于BPPV患者，多次CRP比单次CRP更有益。
