Disclosures: Dylan W. Banks: No financial relationships or conflicts of interest
Objective: To assess the efficacy of canalith repositioning chairs (CRCs) in the treatment of posterior canal benign paroxysmal positional vertigo (PC-BPPV).
Design: Retrospective study of PC-BPPV subjects diagnosed and treated using a CRC from 2014-2019. Setting : Otoneurology clinic specialized in vestibular disorders. Participants : 612 subjects were included. Inclusion criteria: a history of episodes of positionally triggered dizziness as well as identified and recorded torsional nystagmus upon CRC diagnostic testing.
Interventions: Subjects were diagnosed and treated using a CRC with concurrent video-oculography. Diagnostic testing relied upon identification of torsional nystagmus patterns through Dix-Hallpike testing. Treatment included CRC assisted canalith repositioning maneuvers (CRMs). Dix-Hallpike-induced nystagmus was assessed again immediately following treatment.
Main Outcome Measures: Immediately following CRC treatment, changes in BPPV-induced nystagmus were assessed by clinicians via video-oculography recordings. Patient-reported symptomatic changes at follow up visits within 3 months of treatment were compiled and utilized as another measure of treatment success.
Results: PC-BPPV was identified in 612 cases utilizing a CRC as a diagnostic tool. 3 subjects were unable to complete the treatment due to nausea. Post treatment video-oculography assessment indicated 66% (n=405) resolution, 19% (n=195) marked improvement, and 11% (n=70) moderate improvement of BPPV induced nystagmus immediately following treatment. 18 subjects were lost to follow up, leaving 594 subjects that were assessed at their follow up visit for patient-reported symptomatic changes since CRC treatment. Patient reports indicated 20% (n=118) resolution, 55% (n=326) marked improvement, and 21% (n=124) moderate improvement of BPPV-derived symptoms. Conclusions: The present study suggests that the CRC is an effective tool for the treatment of PC-BPPV, which is congruent with the current scientific literature. Compared to traditional table Epley maneuvers, CRCs offer a more standardized treatment and objective nystagmus assessment. Further research into CRCs for other forms of BPPV as well as their cost effectiveness are warranted.
Level of Evidence: Level IV
To cite this abstract in AMA style:
Banks DW, Purcell IM. Treatment of Benign Paroxysmal Positional Vertigo with Canalith Repositioning Chair [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/treatment-of-benign-paroxysmal-positional-vertigo-with-canalith-repositioning-chair/. Accessed September 7, 2024.« Back to AAPM&R Annual Assembly 2020
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/treatment-of-benign-paroxysmal-positional-vertigo-with-canalith-repositioning-chair/