Double-blind randomized controlled trial on efficacy of cupulolith repositioning maneuver for treatment of apogeotropic horizontal canal benign paroxysmal positional vertigo

Abstract

Backgrounds: Although various therapeutic maneuvers have been proposed, it is still unclear which maneuver is better to treat apogeotropic horizontal canal benign paroxysmal positional vertigo (HC-BPPV).

Objectives: This study aimed to assess the therapeutic efficacy of the cupulolith repositioning maneuver (CuRM) in apogeotropic HC-BPPV in comparison with the therapeutic head-shaking maneuver and modified Lempert maneuver.

Materials and Method: This is double-blind randomized prospective study. Forty-nine consecutive patients diagnosed with apogeotropic HC-BPPV were allocated randomly to CuRM (n = 18), therapeutic head-shaking (n = 16), or modified Lempert maneuver (n = 15). The presence of nystagmus and vertigo on positional testing were evaluated at 30 min, on 1 day, and 1 week after treatment.

Results: There were no significant differences in any clinical characteristics between the three groups at randomization. After a single trial of therapeutic maneuvers on the initial visit day, the CuRM (38.9%) and therapeutic head shaking maneuver (12.5%) did not show differences compared to modified Lempert maneuver (33.3%). The therapeutic effects on the 2nd day and at 1 week after treatment also did not differ between the three groups.

Conclusions: Although the CuRM is theoretically considered to be a better therapeutic method, the therapeutic efficacy of CuRM was not statistically different compared to the other two maneuvers.

Chinese abstract

背景：尽管已经提出了各种治疗手段, 但尚不清楚哪种方法能更好地治疗垂直性良性阵发性位置性眩晕（HC-BPPV）。

目的：本研究旨在评估, 与矫正性摇头法和改良的伦珀特法相比, 铜粉重定位法（CuRM）在趋质性HC-BPPV中的治疗效果。

材料和方法：这是双盲随机前瞻性研究。诊断为趋质HC-BPPV的四十九名连续患者被随机分配至CuRM（n = 18）, 治疗性摇头（n = 16）或改良的Lempert治疗法（n = 15）。在治疗后30分钟、第1天和第1周, 评估位置测试中眼球震颤和眩晕的存在。

结果：随机分组时, 三组之间的任何临床特征均无显着差异。在首次就诊日对治疗性操作进行了单次试验后, 与改良的Lempert操作（33.3％）相比, CuRM（38.9％）和治疗性头部摇动操作（12.5％）没有显示差异。两组之间在治疗的第二天和治疗后1周的疗效也没有差异。

结论：尽管理论上认为CuRM是一种更好的治疗方法, 但是与其他两种方法相比, CuRM的治疗效果在统计学上并没有令人满意的差异。

Keywords:

• Benign paroxysmal positional vertigo
• Semicircular canals
• Randomized controlled trial
• Vertigo
• Dizziness

Disclosure statement

No potential conflict of interest was reported by the author(s).