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Vibration Does Not Improve Results of the Canalith Repositioning Procedure
Timothy Carl Hain, MD;
Janet Odry Helminski, PhD;
Igor Levy Reis, MD;
Mohammad Kaleem Uddin, MD
Arch Otolaryngol Head Neck Surg. 2000;126:617-622.
Objective To determine whether, in patients with benign paroxysmal positional vertigo (BPPV), the canalith repositioning procedure performed with vibration applied over the mastoid bone of the affected ear is more effective in resolving the symptoms and preventing recurrence of BPPV than the procedure performed without vibration.
Design Retrospective case review.
Setting Tertiary referral center.
Patients Ninety-four patients diagnosed as having BPPV involving the posterior semicircular canal.
Interventions Patients were assigned to one of 2 treatment groups: the canalith repositioning procedure with vibration (n=44) and with no vibration (n=50).
Main Outcome Measures Effectiveness of treatment was determined through clinical reevaluation or reported through a telephone interview 1 week after treatment. Intensity of symptoms was quantified on a scale of 1 to 3 (mild, moderate, or severe); effectiveness of treatment was categorized on a scale of 1 to 4 (cure, much better, better, or no change). Rate of recurrence was determined through later clinical reevaluation or a telephone interview.
Results At 1 week, 57 of the 94 patients were cured and 16 were much better, providing a 78% overall success rate. There was no significant difference in effectiveness of the treatment or the frequency of reoccurrence of BPPV between the vibration and no-vibration groups as determined from the Kaplan-Meier product-limit method and log-rank test. Rate of recurrence was 47% at a maximum follow-up of 5.25 years.
Conclusions Our results suggest that, while the canalith repositioning procedure is effective in the treatment of BPPV, vibration applied during the maneuver does not significantly affect short-term or long-term outcomes.
From the Departments of Otolaryngology (Drs Hain and Helminski) and Neurology (Drs Hain, Reis, and Uddin), Northwestern University Medical School, Chicago, Ill, and Department of Physical Therapy, Midwestern University, Downers Grove, Ill (Dr Helminski).
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