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Emmanuel Levrat, MD; Guy van Melle, PhD; Philippe Monnier, MD; Raphaël Maire, MD

Arch Otolaryngol Head Neck Surg. 2003;129:629-633.

Objectives  To assess the efficacy of the Semont maneuver in the treatment of benign paroxysmal positional vertigo (BPPV) of the posterior semicircular canal and to evaluate the possible effect of various factors on the efficacy of this maneuver.

Design and Setting  Retrospective study in an outpatient clinic.

Patients  Two hundred seventy-eight patients presenting with symptomatic, unilateral BPPV of the posterior semicircular canal, exclusively treated with the Semont maneuver.

Interventions  During the first consultation, each patient was treated with a Semont maneuver. When BPPV persisted, this maneuver was repeated during follow-up visits, performed at weekly intervals.

Main Outcome Measures  Patients were considered cured when vertigo disappeared within 30 days (allowing up to 4 maneuvers).

Results  More than 90% of patients were cured after a maximum of 4 maneuvers, and 83.5% were cured after only 2 maneuvers. The efficacy of the maneuver decreased each time it was repeated (from 62.6% at the first maneuver to 18.2% at the fourth). The duration of symptoms before initial consultation and the etiology of BPPV had a significant effect on the maneuver's efficacy (P<.001 and P = .002, respectively), whereas age (P = .12), sex (P = .06), and affected side (P = .20) had no effect.

Conclusions  The Semont maneuver demonstrated a 90.3% cure rate after a maximum of 4 sessions. Patients consulting late (>6 months after the beginning of symptoms) or having traumatic BPPV had lower recovery rates than patients without these factors (74.7% vs 96.5%).

From the Otoneurology Unit, Otolaryngology–Head and Neck Surgery Clinic, Centre Hospitalier Universitaire Vaudois (Drs Levrat, Monnier, and Maire), and University Institute of Social and Preventive Medicine (Dr van Melle), Lausanne, Switzerland. The authors have no relevant financial interest in this article.

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