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Benign paroxysmal positional vertigo of the posterior semicircular canal: efficacy of Santiago treatment protocol, long-term follow up and analysis of recurrence

Published online by Cambridge University Press:  06 February 2012

A Soto-Varela ,
M Rossi-Izquierdo ,
G Martínez-Capoccioni ,
T Labella-Caballero  and
S Santos-Pérez
A Soto-Varela*
Affiliation:
Division of Otoneurology, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain Department of Dermatology and Otorhinolaryngology, University of Santiago de Compostela, Santiago de Compostela, Spain
M Rossi-Izquierdo
Affiliation:
Department of Otorhinolaryngology, Hospital Lucus Augusti, Lugo, Spain
G Martínez-Capoccioni
Affiliation:
Department of Otorhinolaryngology, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
T Labella-Caballero
Affiliation:
Department of Otorhinolaryngology, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
S Santos-Pérez
Affiliation:
Division of Otoneurology, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain Department of Dermatology and Otorhinolaryngology, University of Santiago de Compostela, Santiago de Compostela, Spain
*
Address for correspondence: Dr Andrés Soto-Varela, Servicio de Otorrinolaringología, Complejo Hospitario Universitario de Santiago, Travesía da Choupana, s/n, Postal code 15706, Santiago de Compostela, Spain Fax: 0034 981950454 E-mail: andres.soto@usc.es
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Abstract

Objectives:

To evaluate the efficacy of the Santiago treatment protocol for benign paroxysmal positional vertigo of the posterior semicircular canal, to analyse recurrence and to establish prognostic factors.

Material and methods:

Four hundred and twelve patients with unilateral benign paroxysmal positional vertigo of the posterior semicircular canal were treated with the Semont manoeuvre and, if symptoms did not resolve, successive application of three Epley manoeuvres plus Brandt–Daroff exercises.

Results:

Symptoms resolved in 404 patients (98.1 per cent); a single Semont manoeuvre was sufficient in 334 (81.2 per cent). Aetiology had no impact on resolution of symptoms or number of manoeuvres required. The estimated likelihood of recurrence was 14 per cent in the first year and 27 per cent after 10 years. The only factor indicating a worse prognosis was recurrence.

Conclusion:

In unilateral benign paroxysmal positional vertigo of the posterior semicircular canal, the above treatment protocol cured 98 per cent of patients. More than half of recurrences occurred in the first year. None of the analysed factors increased the likelihood of recurrence.

Keywords

VertigoVestibular DiseasesPositional VertigoPhysical Therapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 4 , April 2012 , pp. 363 - 371
Copyright
Copyright © JLO (1984) Limited 2012

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