Objective: To investigate the significance of vHIT (Video Head Impulse Test) in determining the efficacy of therapeutic maneuvers in individuals with posterior semicircular canal (SCC) BPPV. Materials and Methods: The study included 25 patients with posterior SCC BPPV (Study Group), 30 healthy individuals (Control Group). All individuals underwent otorhinolaryngologic examination, audiological evaluation, videonystagmography, vHIT and completed Dizziness Handicap Inventory (DHI) and Visual Analogue Scale (VAS). Modified Epley Maneuver was performed 3 times at an interval of 3 days. The vHIT, DHI and VAS were re-administered to these individuals 1 week after improvement was detected in positional nystagmus. Results: There was no significant difference between the study and control groups in terms of vHIT gains for all bilateral SCCs before therapeutic maneuver (p>0.05). In the study group, there was no significant difference between vHIT gains of all bilateral SSCs before and after therapeutic maneuvers (p>0.05). No asymmetry or refixation saccades (overt and covert) were observed in any of the individuals in both groups during all measurements. Compared to before therapeutic maneuvers, there was a significant decrease in dizziness-related disability level assessed by DHI and intensity of dizziness assessed by VAS in the study group after the improvement (p<0.001). Conclusion: It was found that vHIT was not a diagnostic test in BPPV and in terms of evaluating the efficacy of therapeutic maneuvers. Subjective evaluations determining the intensity of dizziness and level of dizziness-related disability in BPPV provided supportive information in diagnosis and in determining the efficacy of therapeutic maneuvers.
André, A. P. d. R., Moriguti, J. C., & Moreno, N. S. (2010). Conduct after Epley's maneuver in elderly with posterior canal BPPV in the posterior canal. Brazilian journal of otorhinolaryngology, 76, 300-305. https://doi.org/10.1590/S1808-86942010000300005
Anthony, J. C., LeResche, L., Niaz, U., Von Korff, M. R., & Folstein, M. F. (1982). Limits of the ‘Mini-Mental State’as a screening test for dementia and delirium among hospital patients. Psychological medicine, 12(2), 397-408. DOI: https://doi.org/10.1017/S0033291700046730
Blödow, A., Heinze, M., Bloching, M. B., von Brevern, M., Radtke, A., & Lempert, T. (2014). Caloric stimulation and video-head impulse testing in Ménière’s disease and vestibular migraine. Acta oto-laryngologica, 134(12), 1239-1244. https://doi.org/10.3109/00016489.2014.939300
Chen, T., Li, S., Dong, H., Lin, P., Wen, C., Cheng, Y., et al. (2012). Analysis of the dysfunction frequency and characteristics of semicircular canal in benign paroxysmal positional vertigo. Zhonghua er bi yan hou tou jing wai ke za zhi= Chinese journal of otorhinolaryngology head and neck surgery, 47(10), 793-798.
Çınar, Y., Bayram, A., Culfa, R., & Mutlu, C. (2018). Analyses with the video head impulse test during the canalith repositioning maneuver in patients with isolated posterior semicircular canal benign paroxysmal positional vertigo. Turkish archives of otorhinolaryngology, 56(2), 81. http://doi: 10.5152/tao.2018.3166
De Waal, P. (2004). BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV)—A simple solution. Continuing Medical Education, 22(5).
Epley, J. M. (1992). The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo. Otolaryngology—Head and Neck Surgery, 107(3), 399-404. https://doi.org/10.1177/019459989210700310
Eza-Nuñez, P., Fariñas-Alvarez, C., & Perez-Fernandez, N. (2014). The caloric test and the video head-impulse test in patients with vertigo. Journal of International Advanced Otology.
http:// doi:10.5152/IAO.2014.64
Fallahnezhad, T., Ghahraman, M. A., Farahani, S., Hoseinabadi, R., & Jalaie, S. (2017). Vestibulo-ocular reflex abnormalities in posterior semicircular canal benign paroxysmal positional vertigo: a pilot study. Iranian journal of otorhinolaryngology, 29(94), 269. http://doi:10.22038/ijorl.2017.22120.1761
Gacek, R. R. (2013). A perspective on recurrent vertigo. ORL, 75(2), 91-107. https://doi.org/10.1159/000348710
Guan, Q., Zhang, L., Hong, W., Yang, Y., Chen, Z., Zhang, D., et al. (2017). Video head impulse test for evaluation of vestibular function in patients with vestibular neuritis and benign paroxysmal positional vertigo. Journal of Zhejiang University (Medical Science), 46(1), 52-58.
Hall, S., Ruby, R., & McClure, J. (1979). The mechanics of benign paroxysmal vertigo. The Journal of otolaryngology, 8(2), 151-158.
Hornibrook, J. (2011). Benign paroxysmal positional vertigo (BPPV): history, pathophysiology, office treatment and future directions. International journal of otolaryngology, 2011. https://doi.org/10.1155/2011/835671
Jacobson, G. P., & Newman, C. W. (1990). The development of the dizziness handicap inventory. Archives of Otolaryngology–Head & Neck Surgery, 116(4), 424-427. http://doi: 10.1001/archotol.1990.01870040046011
Jorns-Häderli, M., Straumann, D., & Palla, A. (2007). Accuracy of the bedside head impulse test in detecting vestibular hypofunction. Journal of Neurology, Neurosurgery & Psychiatry, 78(10), 1113-1118. http://dx.doi.org/10.1136/jnnp.2006.109512
Karapolat, H., Eyigor, S., Kirazli, Y., Celebisoy, N., Bilgen, C., & Kirazli, T. (2010). Reliability, validity, and sensitivity to change of Turkish Activities-specific Balance Confidence Scale in patients with unilateral peripheral vestibular disease. International Journal of Rehabilitation Research, 33(1), 12-18. http://doi: 10.1097/mrr.0b013e32832c0d72
Khatri, M., Raizada, R., & Puttewar, M. (2005). Epley's canalith-repositioning manoeuvre for benign paroxysmal positional vertigo. Indian Journal of Otolaryngology and Head and Neck Surgery, 57(4), 315. http:// doi: 10.1007/BF02907697
Kollén, L., Bjerlemo, B., & Möller, C. (2006). Evaluation of treatment in benign paroxysmal positional vertigo (BPPV). Advances in Physiotherapy, 8(3), 106-115. https://doi.org/10.1080/14038190600836866
Mangabeira Albernaz, P. L., & Zuma e Maia, F. C. (2014). The video head impulse test. Acta oto-laryngologica, 134(12), 1245-1250. https://doi.org/10.3109/00016489.2014.942439
Ozgirgin, O. N., & Tarhan, E. (2008). Epley maneuver and the head autorotation test in benign paroxysmal positional vertigo. European archives of oto-rhino-laryngology, 265(11), 1309-1313. http://doi: 10.1007/s00405-008-0643-7
Parnes, L. S., & Mcclure, J. A. (1992). Free‐floating endolymph particles: a new operative finding during posterior semicircular canal occlusion. The Laryngoscope, 102(9), 988-992. https://doi.org/10.1288/00005537-199209000-00006
Schuknecht, H. F. (1969). Cupulolithiasis. Archives of Otolaryngology, 90(6), 765-778.
Semont, A., Freyss, G., & Vitte, E. (1988). Curing the BPPV with a liberatory maneuver. In Clinical testing of the vestibular system (Vol. 42, pp. 290-293). Karger Publishers. https://doi.org/10.1159/000416126
Solomon, D. (2000). Benign paroxysmal positional vertigo. Current treatment options in neurology, 2(5), 417-427. http://doi:10.1007/s11940-000-0040-z
Toupet, M., Ferrary, E., & Grayeli, A. B. (2011). Visual analog scale to assess vertigo and dizziness after repositioning maneuvers for benign paroxysmal positional vertigo. Journal of Vestibular Research, 21(4), 235-241. http://doi: 10.3233/VES-2011-0420
Von Brevern, M., Bertholon, P., Brandt, T., Fife, T., Imai, T., Nuti, D., et al. (2015). Benign paroxysmal positional vertigo: diagnostic criteria. Journal of Vestibular Research, 25(3, 4), 105-117. http://doi: 10.3233/VES-150553
Weber, K., Aw, S., Todd, M., McGarvie, L., Curthoys, I., & Halmagyi, G. (2008). Head impulse test in unilateral vestibular loss: vestibulo-ocular reflex and catch-up saccades. Neurology, 70(6), 454-463. http://doi: 10.1212/01.wnl.0000299117.48935.2e
Wewers, M. E., & Lowe, N. K. (1990). A critical review of visual analogue scales in the measurement of clinical phenomena. Research in nursing & health, 13(4), 227-236. https://doi.org/10.1002/nur.4770130405
André, A. P. d. R., Moriguti, J. C., & Moreno, N. S. (2010). Conduct after Epley's maneuver in elderly with posterior canal BPPV in the posterior canal. Brazilian journal of otorhinolaryngology, 76, 300-305. https://doi.org/10.1590/S1808-86942010000300005
Anthony, J. C., LeResche, L., Niaz, U., Von Korff, M. R., & Folstein, M. F. (1982). Limits of the ‘Mini-Mental State’as a screening test for dementia and delirium among hospital patients. Psychological medicine, 12(2), 397-408. DOI: https://doi.org/10.1017/S0033291700046730
Blödow, A., Heinze, M., Bloching, M. B., von Brevern, M., Radtke, A., & Lempert, T. (2014). Caloric stimulation and video-head impulse testing in Ménière’s disease and vestibular migraine. Acta oto-laryngologica, 134(12), 1239-1244. https://doi.org/10.3109/00016489.2014.939300
Chen, T., Li, S., Dong, H., Lin, P., Wen, C., Cheng, Y., et al. (2012). Analysis of the dysfunction frequency and characteristics of semicircular canal in benign paroxysmal positional vertigo. Zhonghua er bi yan hou tou jing wai ke za zhi= Chinese journal of otorhinolaryngology head and neck surgery, 47(10), 793-798.
Çınar, Y., Bayram, A., Culfa, R., & Mutlu, C. (2018). Analyses with the video head impulse test during the canalith repositioning maneuver in patients with isolated posterior semicircular canal benign paroxysmal positional vertigo. Turkish archives of otorhinolaryngology, 56(2), 81. http://doi: 10.5152/tao.2018.3166
De Waal, P. (2004). BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV)—A simple solution. Continuing Medical Education, 22(5).
Epley, J. M. (1992). The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo. Otolaryngology—Head and Neck Surgery, 107(3), 399-404. https://doi.org/10.1177/019459989210700310
Eza-Nuñez, P., Fariñas-Alvarez, C., & Perez-Fernandez, N. (2014). The caloric test and the video head-impulse test in patients with vertigo. Journal of International Advanced Otology.
http:// doi:10.5152/IAO.2014.64
Fallahnezhad, T., Ghahraman, M. A., Farahani, S., Hoseinabadi, R., & Jalaie, S. (2017). Vestibulo-ocular reflex abnormalities in posterior semicircular canal benign paroxysmal positional vertigo: a pilot study. Iranian journal of otorhinolaryngology, 29(94), 269. http://doi:10.22038/ijorl.2017.22120.1761
Gacek, R. R. (2013). A perspective on recurrent vertigo. ORL, 75(2), 91-107. https://doi.org/10.1159/000348710
Guan, Q., Zhang, L., Hong, W., Yang, Y., Chen, Z., Zhang, D., et al. (2017). Video head impulse test for evaluation of vestibular function in patients with vestibular neuritis and benign paroxysmal positional vertigo. Journal of Zhejiang University (Medical Science), 46(1), 52-58.
Hall, S., Ruby, R., & McClure, J. (1979). The mechanics of benign paroxysmal vertigo. The Journal of otolaryngology, 8(2), 151-158.
Hornibrook, J. (2011). Benign paroxysmal positional vertigo (BPPV): history, pathophysiology, office treatment and future directions. International journal of otolaryngology, 2011. https://doi.org/10.1155/2011/835671
Jacobson, G. P., & Newman, C. W. (1990). The development of the dizziness handicap inventory. Archives of Otolaryngology–Head & Neck Surgery, 116(4), 424-427. http://doi: 10.1001/archotol.1990.01870040046011
Jorns-Häderli, M., Straumann, D., & Palla, A. (2007). Accuracy of the bedside head impulse test in detecting vestibular hypofunction. Journal of Neurology, Neurosurgery & Psychiatry, 78(10), 1113-1118. http://dx.doi.org/10.1136/jnnp.2006.109512
Karapolat, H., Eyigor, S., Kirazli, Y., Celebisoy, N., Bilgen, C., & Kirazli, T. (2010). Reliability, validity, and sensitivity to change of Turkish Activities-specific Balance Confidence Scale in patients with unilateral peripheral vestibular disease. International Journal of Rehabilitation Research, 33(1), 12-18. http://doi: 10.1097/mrr.0b013e32832c0d72
Khatri, M., Raizada, R., & Puttewar, M. (2005). Epley's canalith-repositioning manoeuvre for benign paroxysmal positional vertigo. Indian Journal of Otolaryngology and Head and Neck Surgery, 57(4), 315. http:// doi: 10.1007/BF02907697
Kollén, L., Bjerlemo, B., & Möller, C. (2006). Evaluation of treatment in benign paroxysmal positional vertigo (BPPV). Advances in Physiotherapy, 8(3), 106-115. https://doi.org/10.1080/14038190600836866
Mangabeira Albernaz, P. L., & Zuma e Maia, F. C. (2014). The video head impulse test. Acta oto-laryngologica, 134(12), 1245-1250. https://doi.org/10.3109/00016489.2014.942439
Ozgirgin, O. N., & Tarhan, E. (2008). Epley maneuver and the head autorotation test in benign paroxysmal positional vertigo. European archives of oto-rhino-laryngology, 265(11), 1309-1313. http://doi: 10.1007/s00405-008-0643-7
Parnes, L. S., & Mcclure, J. A. (1992). Free‐floating endolymph particles: a new operative finding during posterior semicircular canal occlusion. The Laryngoscope, 102(9), 988-992. https://doi.org/10.1288/00005537-199209000-00006
Schuknecht, H. F. (1969). Cupulolithiasis. Archives of Otolaryngology, 90(6), 765-778.
Semont, A., Freyss, G., & Vitte, E. (1988). Curing the BPPV with a liberatory maneuver. In Clinical testing of the vestibular system (Vol. 42, pp. 290-293). Karger Publishers. https://doi.org/10.1159/000416126
Solomon, D. (2000). Benign paroxysmal positional vertigo. Current treatment options in neurology, 2(5), 417-427. http://doi:10.1007/s11940-000-0040-z
Toupet, M., Ferrary, E., & Grayeli, A. B. (2011). Visual analog scale to assess vertigo and dizziness after repositioning maneuvers for benign paroxysmal positional vertigo. Journal of Vestibular Research, 21(4), 235-241. http://doi: 10.3233/VES-2011-0420
Von Brevern, M., Bertholon, P., Brandt, T., Fife, T., Imai, T., Nuti, D., et al. (2015). Benign paroxysmal positional vertigo: diagnostic criteria. Journal of Vestibular Research, 25(3, 4), 105-117. http://doi: 10.3233/VES-150553
Weber, K., Aw, S., Todd, M., McGarvie, L., Curthoys, I., & Halmagyi, G. (2008). Head impulse test in unilateral vestibular loss: vestibulo-ocular reflex and catch-up saccades. Neurology, 70(6), 454-463. http://doi: 10.1212/01.wnl.0000299117.48935.2e
Wewers, M. E., & Lowe, N. K. (1990). A critical review of visual analogue scales in the measurement of clinical phenomena. Research in nursing & health, 13(4), 227-236. https://doi.org/10.1002/nur.4770130405
Haci Hüseyin Dere
ANKARA YILDIRIM BEYAZIT UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF SURGICAL MEDICINE, DEPARTMENT OF EAR, NOSE AND THROAT DISEASES0000-0003-0750-9590Türkiye
Karababa, E., Dere, H. H., Müjdeci, D., Karataş, E. (2022). Comparision of Video Head Impulse Test Findings Before and After Therapy Maneuvers in Individuals with Benign Paroxysmal Positional Vertigo. Hacettepe University Faculty of Health Sciences Journal, 9(2), 362-373. https://doi.org/10.21020/husbfd.1039638