Comparison of semont's maneuver and epley's maneuver with and without betahistine therapy in relieving vertigo in posterior semicircular canal benign paroxysmal positional vertigo

Context: Benign paroxysmal positional vertigo (BPPV) is a disorder characterized by attacks of vertigo and nystagmus and aggravated with changes in head posture. BPPV can be treated effectively by relocating otoconia from the semicircular canal duct into the vestibule using different repositioning maneuvers. Our study is to determine the role of maneuvers in BPPV and to study the efficacy of the maneuvers in BPPV. Aims: The aim of this study is (1) to determine the role of Semont's and Epley's maneuver in BPPV and (2) to study the efficacy of these maneuvers with or without betahistine therapy. Settings and Design: A prospective study was done on sixty BPPV patients from Department of ENT, A. J. Institute of Medical Sciences, Mangalore. Subjects and Methods: Inclusion criteria were positive Dix-Hallpike maneuver and normal pure tone audiometry. Exclusion criteria were cervical spondylosis, multiple canal disease, and inner ear disease. Patients were selected based on above criteria, were examined for posterior semicircular canal BPPV, and further divided into four groups by random selection. Different treatment modalities are used. Statistical Analysis Used: Wilcoxon signed ranks test was used for statistical analysis. Results: The evaluation of outcome was done at the end of 4th week and after 3 months of the initial therapy with Dix-Hallpike and the quality of life was evaluated using visual analog scale for Vertigo and Dizziness Handicap Inventory. The results were compared using the above scales before and after the treatment. Conclusions: Vertigo is a common symptom which has significant morbidity physically and economically. These maneuvers are safe, short, inexpensive, and effective in treating posterior semicircular BPPV and can be practiced regularly.