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

Abstract

Received April 16, 2012 Revised June 30, 2012 Accepted July 3, 2012 Address for correspondence Kyu Hwan Jung, MD Department of OtorhinolaryngologyHead and Neck Surgery, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan 612-030, Korea Tel +82-51-797-0665 Fax +82-51-797-2304 E-mail kwmedi@gmail.com Background and ObjectivesZZBenign 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 MethodZZThirty-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. ResultsZZThe 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). ConclusionZZThe 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. Korean J Otorhinolaryngol-Head Neck Surg 2012;55:429-34