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Particle repositioning manoeuvre in benign paroxysmal positional vertigo: is it really safe?
Simhadri Sridhar1, Naresh Panda
1Department of Otorhinolaryngology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Objective:
A prospective study to determine the safety of the particle repositioning manoeuvre (PRM) by analyzing the various complications of the procedure.
Settings:
Outpatient Department of Otorhinolaryngology, Nehru Hospital, Chandigarh, India.
Methods:
Thirty patients with the classic findings of benign paroxysmal positional vertigo (BPPV) were included in the study. Clinical symptoms prior to the procedure were noted. Twenty-nine of them were subjected to PRM, and postprocedural instructions were given to all patients. Various side effects during and following the procedure were recorded. They were classified into early and late based on the period and into major and minor based on severity. All patients were reviewed after 3 days, 7 days, and 1 month.
Results:
Of the 29 patients, 19 patients (65.52%) had heaviness in the head, with 11 each (37.93%) reporting nausea and imbalance and 9 (31.03%) reporting instability during the procedure. A major complication, asystole, was noted in one patient. The percentage of side effects remained more or less the same in the early phase following the procedure. Only 5 of 29 patients were entirely asymptomatic. Ninety percent were relieved of symptoms by the end of 7 days, with no major complication recorded.
Conclusions:
PRM is an easy, effective, and relatively safe procedure. The risk of major complications with PRM, such as arrhythmias and asystole, highlights the need to consider other management modalities for BPPV in certain medically unfit patients.
