Kanalit repozisyon manevralarının benign paroksismal pozisyonel vertigo tedavisinde kullanımı

Abstract

Amaç: Günümüzde acil servise başvuran hastaların toplam %2-3’ünü vertigo şikayeti oluşturmaktadır. Özellikle 60 yaş üzerinde sıklıkla görülen başdönmesi kişinin sosyal hayatını ve yaşayışını engellemekte; hatta yaşlı hastalarda düşmeye yol açarak hayati tehlikelere neden olabilmektedir. Çalışmamızda; en sık periferik başdönmesi nedeni olan benign paroksizmal pozisyonel vertigo tedavisinde kullanılan Epley manevrasının hastanın şikayetleri üzerine etkisini araştırdık.

Yöntem: Kulak burun boğaz hastalıkları ve acil servise başvuran ve periferik kökenli olduğu tahmin edilen 347 hasta araştırmamıza katıldı. Hastalara Epley manevrası yapılmasının ardından iyileşmeleri takip edildi.

Bulgular: Araştırmamıza katılan 347 hastanın; 201 kadın (%58); 146 erkek (%42), yaş ortalaması 51,23 olarak bulundu. Hastaların %54,46’sı posterior kanal; %34,87’si horizontal kanal; %6,34’ü anterior kanal; %4,32’si çoklu kanal tutulumu göstermektedir. Epley manevrası her hastaya yapılmış ve %94 başarı sağlanmıştır.

Sonuç: BPPV tedavisinde Epley repozisyon manevrası, basit, güvenli, hızlı ve etkinliği yüksek bir yöntemdir.

Keywords

• Başdönmesi,bppv,epley,manevra,vertigo

The use of Canalith Reposition Maneuvers in Treatment of Benign Paroxysmal Positional Vertigo

Abstract

Objective: Patients with vertigo compose 2-3% of total admissions to emergency department. Dizziness affects especially the patients above 60 years of age creating social life difficulties and causing, leads to dangerous and life-threatening situations. In this study, we tried to show the effect of Epley maneuver on the symptoms of benign paroxysmal positional vertigo (BPPV) which is the most common type of peripheric vertigo. Method: A total of 347 patients who attended to otolaryngology and emergency departments of Ufuk University and Private Medisun Hospital between 15.08.2018 and 15.02.2019 with peripheric vertigo complaints were included in the study. Each patient was applied Epley maneuver and followed. Results were analyzed with SPSS program (Statistical Package for Social Sciences). Results: Of all the patients, 201 (58%) were women, and 146 (42%) were men with a mean age of 51,2±3,1 years. Posterior semicircular canal pathology was found in 54.5%; horizontal canal in 34.9%; anterior canal in 6.3%; multiple canal in 4.3%. Epley maneuver was applied to all patients and succeeded in 94% of the patients. Conclusion: Vertigo is a common symptom that can cause serious effects on lifestyle. Searching the etiology can be challenging for both the physicians and the patients. The most common cause of peripheral vertigo is BPPV. Epley maneuver is a simple, safe, quick and effective method for treatment and the diagnosis of BPPV. In conclusion, using canalith reposition maneuvers firstly will decrease the recovery time and save patients from time loss.

Keywords

• vertigo,epley maneuver,treatment

References

1. 1. Young P, Castillo-Bustamante M, Almiron CJ, Bruetman JE, Finn BC, Ricardo MA ve ark. Approach to patients with vertigo. Medicina B Aires. 2018;78(6):410-416
2. 2. Sahin E, Deveci I, Dinc ME, Ozker BY, Bicer C, Erel O. Oxidative Status in Patients with Benign Paroxysmal Positional Vertigo. J Int Adv Otol. 2018;14(2):299-303.
3. 3. Vugt VA, Nerio PMD; Wounden JC, Horst HE, Maarsingh OR. Use of canalith repositioning manoeuvres and vestibular rehabilitation: a GP survey. Scandinavian Journal of Primary Health Care. 2017; 35(1): 19-26.
4. 4. Álvarez-Morujo de Sande MG, González-Aguado R, Guerra-Jiménez G, Domènech-Vadillo E, Galera-Ruiz H, Figuerola-Massana E, Ramos-Macías Á, Morales-Angulo C, Martín-Mateos AJ, Domínguez-Durán E. Probable benign paroxysmal positional vertigo, spontaneously resolved: Incidence in medical practice, patients' characteristics and the natural course. J Otol. 2019;14(3):111-116
5. 5. Colin L, Driscol W, Douglas Green Jr. Denge Testleri. In: Bailey BJ, Johnson J, ed. Baş ve Boyun Cerrahisi Otolarengoloji. Ankara: Güneş Tıp Kitabevi; 2011. p.1917-1927.
6. 6. Balatsouras DG, Koukoutsis G, Fassolis A, Moukos A, Apris A. Benign paroxysmal positional vertigo in the elderly current insights. Clin Interv Aging. 2018; 13: 2251–2266
7. 7. Bruintjes TD, Companjen J, van der Zaag-Loonen HJ, van Benthem PP. A randomised sham-controlled trial to assess the long-term effect of the Epley manoeuvre for treatment of posterior canal benign paroxysmal positional vertigo. Clin Otolaryngol. 2014;39(01):39–44.
8. 8. Wang YH, Chan CY, Liu QH. Benign paroxsymal positional vertigo - recommendations for treatment in primary care. There Clin Risk Management. 2019; 11(15):719-25

9. 9. Ceryan K, Şerbetçioğlu MB. Baş Dönmesi Olan Hastada Öykü Muayene ve Tanı. In: Celik O, ed. Kulak Burun Boğaz Hastalıkları ve Baş Boyun Cerrahisi. İzmir: META basım matbaacılık; 2007. p. 36-63.
10. 10. Jonsson R, Sixt E, Landahl S, Rosenhall U. Prevalence of dizziness and vertigo in an urban elderly population. J Vestib Res. 2004;14:47–52.
11. 11. Andrade LR, Lins U, Farina M, Kachar B, Thalmann R. Immunogold TEM of otoconin 90 and otolin: relevance to mineralization ofotoconia, and pathogenesis of benign positional vertigo. Hear Res. 2012;292(1–2):14–25.
12. 12. Ozluoglu L, Tarhan E. Periferik Vertigo Nedenleri. In: Koç Can, ed. Kulak Burun Boğaz Hastalıkları ve Baş Boyun Cerrahisi. Ankara: Güneş Tıp Kitabevi; 2013. p.307-315.
13. 13. Ogun OA, Buki B, Cohn ES, Janky KL, Lundberg YW. Menopause and benign paroxysmal positional vertigo. Menopause. 2014;21(8):886-9.
14. 14. Chen J, Nathans J. Estrogen-related receptor beta/NR3B2 controls epithelial cell fate and endolymph production by the stria vascularis. Dev Cell. 2007 Sep;13(3):325–37.
15. 15. Cohen HS, Kimball KT. Treatment variations on the Epley maneuver for benign paroxysmal positional vertigo. Am J Otolaryngol 2004 Jan-Feb;25(1):33-7.
16. 16. Karkos PD, Leong SC, Papouliakos SM, Korres SG, Thong JF. Semont's maneuver in BPPV: a forgotten technique. Clin Otolaryngol 2006 Oct;31(5):464-5.
17. 17. Lee JD, Shim DB, Park H, Song CI, Kim MB, Kim CH, Byun JY, Hong SK, Kim TS, Park KH, Seo JH, Shim BS, Lee JH, Jeon EJ. A multicenter randomized double-blind study: comparison of the Epley, Semont, and sham maneuvers for the treatment of posterior canal benign paroxysmal positional vertigo. Audiol Neurootol. 2014;19(05):336–341
18. 18. Prokopakis E, Vlastos IM, Tsagournisakis M, Christodoulou P, Kawauchi H, Velegrakis G. Canalith repositioning procedures among 965 patients with benign paroxysmal positional vertigo. Audiol Neurootol. 2013;18(02):83–88.
19. 19. Rodrigues DL, Ledesma ALL, de Oliveira CAP, Junior FB. Physical Therapy for Posterior and Horizontal Canal Benign Paroxysmal Positional Vertigo: Long-term Effect and Recurrence: A Systematic Review. Int Arch Otorhinolaryngol. 2018 Oct; 22(4): 455–459.
20. 20. Asawavichianginda S, Isipradit P, Snidvongs K, Supiyaphun P. Canalith repositioning for benign paroxysmal positional vertigo: a randomized, controlled trial. Ear Nose Throat J. 2000;79(9): 732-4, 736-737.
21. 21. Bhattacharyya N, Gubbels SP, Schwartz SR, Edlow JA, El-Kashlan H, Fife T, Holmberg JM, Mahoney K, Hollingsworth DB, Roberts R, Seidman MD, Steiner RW, Do BT, Voelker CC, Waguespack RW, Corrigan MD . Clinical Practice Guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg. 2017;156(3 Suppl):S1–S47
22. 22. Parham K, Kuchel GA. A geriatric perspective on benign paroxysmal positional vertigo. J Am Geriatr Soc. 2016;64(2):378–385.
23. 23. Wan TJ, Yu YC, Zhao XG, Tang P, Gong YS. Efficacy of betahistine plus cognitive behavioral therapy on residual dizziness after successful canalith repositioning procedure for benign paroxysmal positional vertigo. Neuropsychiatr Dis Treat. 2018;5(14):2965-71.
24. 24. Johnson J, Lalwani AK.Vestibuler Disorders.In Lalwani AK, ed. Current Diagnosis And Treatment İn Otolaryngology Head And Neck Surgery. USA: McGraw-Hill; 2012. p.729-32.