[Semont maneuver vs. particle repositioning maneuver: comparative study]

Area of Science:

• Neurology
• Otolaryngology
• Vestibular Disorders

Background:

• Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder.
• Posterior semicircular canal BPPV is frequently treated with repositioning maneuvers.
• Evaluating treatment effectiveness and identifying reliable indicators is crucial for clinical practice.

Purpose of the Study:

• To evaluate the effectiveness of the Particle Repositioning Maneuver (PRM) and the Semont Maneuver for posterior semicircular canal BPPV.
• To analyze secondary nystagmus (Ny) and re-test results as indicators of therapeutic maneuver effectiveness.

Main Methods:

• Eighty consecutive patients with posterior semicircular canal BPPV were treated.
• Forty patients received the Particle Repositioning Maneuver (PRM).
• Forty patients received the Semont Maneuver, with assessment of secondary nystagmus and Hallpike re-test after 15 minutes.

Main Results:

• Overall recovery rates were 80% after the first session and 95% by the third session.
• The Semont Maneuver demonstrated higher rates of secondary liberating nystagmus (80%) and initial effectiveness (75% in one session).
• PRM showed higher overall effectiveness (85% in one session) but lower induction of secondary nystagmus (25%).

Conclusions:

• The Semont Maneuver is advantageous due to its high therapeutic effectiveness and reliable induction of secondary nystagmus, allowing for immediate re-testing and potential maneuver repetition.
• PRM is highly effective, but its lower rate of secondary nystagmus suggests relying on follow-up assessments rather than immediate re-testing for treatment confirmation.
• Both maneuvers are effective, but the choice may depend on the clinician's preference for immediate feedback versus overall long-term efficacy.