Benign Paroxysmal Positional Vertigo; a Comparison between Particle Reposition Maneuver (Modified Epley›s Maneuver) and Medical Therapy

Arsalan Awlla Mustafa  Shem; Basil Mohammed Nather  Saeed; Tahir Islam  Mohammed

doi:10.56056/amj.2017.18

Authors

Arsalan Awlla Mustafa Shem FICMS, CABS, EBE (ORL-HNS), Assist. Professor & Consultant Otolaryngologist, Rizgary Teaching Hospital/ Otolaryngology Department, Hawler .Medical University- College of Medicine
Basil Mohammed Nather Saeed FICMS, Assist. Professor & Consultant Otolaryngologist, University of Mosul-College of Medicine/ Department of Surgery,
Tahir Islam Mohammed FICMS, Rizgary Teaching Hospital/ Otolaryngology Department, Directory of Health,

DOI:

https://doi.org/10.56056/amj.2017.18

Keywords:

Benign paroxysmal positional vertigo, Dix-Hallpike maneuver, Betahistine-HCl, Particle Reposition Maneuver

Abstract

Background and objectives: paroxysmal positional vertigo is the most common disorder causing dizziness.Most of the studies confirm the effectiveness of particle reposition maneuver in the management of benign paroxys- mal positional vertigo but still many otologists recommending medical therapy for this disorder; therefore this study has been conducted to evaluate the effect of particle reposition maneuver versus medical therapy by Betahistine-HCl for treatment of benign paroxysmal positional vertigo.

Methods: This prospective comparative study was conducted in Otolaryngology department at Rizgary hospital from January 2014 till December 2015. One hundred & fifty patients were selected randomly for either PRM or treatment by Betahistine-HCl as modalities for treatment of posterior canal benign paroxysmal positional vertigo.

Results: The mean age of the patients was (54.56 ±11.160) years. The male to female ratio was 1:2. 60% of patients presented with previous history of vertigo, 30.5% of patients had an associated age related hearing loss. The number of patients, who responded to particle reposition maneuver, was 60 patients out of 72 patients with success rate of 83.3%. While the number of patients who responded to treatment by Betahis- tine-HCl and had negative Dix-Hallpike maneuver were 27 patients out of 70 patients with a success rate of 38.3%.

Conclusions: The study confirms effectiveness of the particle reposition maneuver in the management of benign par- oxysmal positional vertigo, compared to medical therapy by Betahistine, which has inferior outcome in the treatment of BPPV. Betahistine-HCl may have a role when particle reposition maneuver fails or contraindicated.

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