Early Effect of Barbecue Rotation and Modified Semont Combination in Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo

Jung, Kyu Hwan; Baek, Moo Jin; Kim, Yong Wan

Abstract

BACKGROUND AND OBJECTIVES
Benign paroxysmal positional vertigo (BPPV) of horizontal canal shows reversible direction changing positional nystagmus and diverse clinical courses because of the frequent clinical presentation of cupulolithiasis. The aim of this study is to find out the early effect of particle repositioning maneuver (PRM) including the barbecue and the modified Semont in single treatment session for the apogeotropic horizontal canal BPPV.
SUBJECTS AND METHOD
Thirty-three episodic vertigo patients with direction-changing apogeotropic horizontal nystagmus were enrolled in this study. The patients were initially treated with barbecue rotation and the second PRM was applied 15 minutes after the first PRM. Barbecue rotation was applied when the positional nystagmus was changed its direction to that of geotropic. The modified Semont maneuver or barbecue rotation was randomly applied when nystagmus was not changed. Patients were followed-up 2 or 3 days after the initial visit and the nystagmus was rechecked to determine the single session treatment result.
RESULTS
The combination of PRMs in a single treatment session was effective in 23 out of 33 (69.7%) patients. An initial barbecue rotation was effective in 17 patients (51.5%); geotropic nystagmus was obtained in 12, and no nystagmus in 5. Eleven out of 16 (68.8%) patients with persistent apogeotropic nystagmus after initial treatment were successfully treated with the second PRM. There was no statistical difference between the second PRMs of the modified Semont maneuver and barbecue rotation (p=1.000).
CONCLUSION
The combination of PRMs including barbecue rotation and the modified Semont maneuver in a single treatment session showed a comparable success rate as the previously reported studies.