![]() Informed consent forms were signed by all patients. Methodsīetween March 2020 and August 2020, ninety-six patients diagnosed with posterior semicircular canal canalolithiasis were prospectively studied after obtaining local ethical approval (2020/27). In this study, the results of Berg Balance Scale (BBS) and Dizziness Handicap Index (DHI) were evaluated in patients who underwent head-shaking maneuver before EM and who underwent EM without head-shaking maneuver before treatment and at the 1st week after treatment. 10 In the light of these studies, we hypothesized that applying head-shaking before EM in patients with posterior canal canalolithiasis may increase the success of EM. reported that in the lateral canal apogeotropic BPPV, otoliths on the utricular side would be released by head-shaking and then with barbecue maneuvers successfully treated. stated that applying DM after head-shaking maneuver will help to make an accurate diagnosis. The reason was the increase in the movement of adhering otoliths, and when DM was applied with head-shaking, the correct diagnosis rate increased by 14.8%. stated that the patients with BPPV negative were found to be BPPV positive as a result of the application DM with headshaking. 6 The success rate of EM is ranged between 75%–89%. in their review with 11 studies, they stated that the Epley Maneuver (EM) is a safe and effective treatment for posterior canal BPPV. Various treatment maneuvers are available in posterior canal BPPV. 5 Otolith repositioning maneuvers are applied to the patients diagnosed with canalolithiasis. Posterior canal cupulolithiasis is diagnosed in patients with DM with no latency and no fatigue by upward geotropic duration longer than one minute. Posterior canal canalolithiasis is diagnosed in patients with upward geotropic and tired nystagmus that lasts less than a minute, with latency duration of a few seconds with DM. The diagnosis of BPPV is performed by using the Dix–Hallpike Maneuver (DM). The most commonly involved canal is the posterior semicircular canal and the form of posterior canal canalolithiasis is mostly observed. Cupulolithiasis occurs by the adhesion of otoliths in the cupule of the crista ampullaris. Canalolithiasis occurs when otoliths enter the canal from the non-bulbs end and move freely in the canal. This can happen in two different ways: canalolithiasis and cupulolithiasis. Otoliths called autoconial debris that pass from the utricular macula to the semicircular canal are responsible for the pathogenesis of BPPV. 1,2 The specific cause of BPPV is still unknown, however it may be associated with various disorders of the inner ear or head trauma. BPPV can occur at any age, however it is most frequently detected between the 5th and 7thdecades. It has been reported in the literature that the prevalence of BPPV can vary between 10.7–64/100,000 and the lifetime prevalence can reach 2.1%. Typically, each vertigo attack lasts less than one minute. BPPV is defined as an abnormal sensation of movement, usually evoked by sudden head movements. ConclusionĪs a result of our hypothesis, we think that in the treatment of posterior semicircular canal BPPV, the otoliths adhered to the canal can be mobilized by the head-shaking maneuver, and this will contribute to the increase of the effectiveness of the Epley maneuver.īenign paroxysmal positional vertigo (BPPV), which was first identified by Barany, is the most common peripheral vestibular pathologic condition. Although, the change in emotional dizziness handicap index values in Group 2 was higher than those in Group 1, no statistical significance was found between the groups. It was determined that the change in functional and physical dizziness handicap index and Berg balance scale values of the patients in Group 2 was statistically higher than those in Group 1. The improvement in functional, emotional, and physical dizziness handicap index and Berg balance scale values after the treatment was found to be statistically significant in both groups. The results of the Berg balance scale and dizziness handicap index were evaluated before the treatment and at the first week after the treatment. The patients were divided into two groups: patients who underwent the Epley maneuver only in the treatment (Group 1) and patients who underwent the Epley maneuver after the head-shaking maneuver (Group 2). Methodsīetween March 2020 and August 2020, ninety-six patients with posterior semicircular canal BPPV were analyzed prospectively. In this study, the effectiveness of the head-shaking maneuver before the Epley maneuver was investigated in the treatment of BPPV. However, dizziness and balance problems do not improve immediately after the treatment. The Epley maneuver is applied in the treatment of benign paroxysmal positional vertigo, the BPPV.
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