Semont maneuver vs. Epley maneuver for canalithiasis of the posterior semicircular canal: a systematic review

Abstract

Background: The Epley maneuver is generally considered to be the preferred initial treatment for canalithiasis of the posterior semicircular canal. Although the Semont maneuver was originally developed to treat patients with posterior canal cupulolithiasis, several studies have demonstrated successful outcomes when the Semont maneuver is used to treat patients with posterior canal canalithiasis.

Objectives: The purpose of this systematic review was to evaluate the effectiveness of the Semont maneuver to treat canalithiasis of the posterior semicircular canal as compared to that of the Epley maneuver.

Methods: Applicable research articles were obtained through a literature search of the Cumulative Index to Nursing and Allied Health Literature Complete, ProQuest Medical Library, and PubMed databases using the search terms ‘Semont’ AND ‘Epley’ AND ‘randomized’ AND ‘positional vertigo’ OR ‘positioning vertigo’ OR ‘positional nystagmus’ OR ‘positioning nystagmus.’ The Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence was used to assess the evidence level for all of the included studies, and the PEDro Scale was used to assess the methodological rigor for all of the included studies.

Results: Six studies were ultimately included in the qualitative synthesis. In four of these studies, no statistically significant difference was identified between the Semont maneuver and the Epley maneuver.

Conclusions: In most cases, the Semont maneuver was equally as effective as the Epley maneuver at treating posterior canal canalithiasis. In addition, the Semont maneuver should be considered as an alternative treatment option for patients with certain types of cervical, lumbar, cardiac, or respiratory pathologies.

Keywords:

• Benign paroxysmal positional vertigo
• Canalithiasis
• Posterior semicircular canal
• Semont maneuver
• Vestibular rehabilitation