Therapeutic Efficacy of the Modified Epley Maneuver With a Pillow Under the Shoulders.
Identifieur interne : 000007 ( Main/Exploration ); précédent : 000006; suivant : 000008Therapeutic Efficacy of the Modified Epley Maneuver With a Pillow Under the Shoulders.
Auteurs : Hyun Jin Lee [Corée du Sud] ; Eun-Ju Jeon [Corée du Sud] ; Dong-Hee Lee [Corée du Sud] ; Jae-Hyun Seo [Corée du Sud]Source :
- Clinical and experimental otorhinolaryngology [ 1976-8710 ] ; 2020.
Abstract
Objectives
Canalolithiasis of the posterior semicircular canal (PC) is the most common reason for benign paroxysmal positional vertigo (BPPV). If a patient is diagnosed with PC-BPPV through the Dix-Hallpike test, the modified Epley maneuver (mEpley) is used as the gold standard treatment. To reduce the discomfort of the standard mEpley, we proposed placing a pillow under the shoulders during this therapeutic maneuver. The purpose of this study was to determine whether the therapeutic efficacy of the mEpley with a pillow under the shoulders (mEpley-PS) was comparable to that of the standard mEpley.
Methods
A randomized controlled study at three academic referral hospitals was conducted in compliance with the CONSORT statement. Patients who were diagnosed with PC-BPPV through the Dix-Hallpike test were randomly assigned to groups A or B. Patients in groups A and B were treated with the standard mEpley and mEpley-PS, respectively. The resolution of vertigo and nystagmus on the Dix-Hallpike test at a 1-week follow-up after treatment was the main outcome measurement to assess the efficacy of treatment.
Results
Forty-one patients diagnosed with PC-BPPV were enrolled in this study. Twenty-one patients were assigned to group A and 20 were assigned to group B. The success rate at 1 week after treatment was 85.7% in group A and 80.0% in group B. There was no statistically significant difference between the two groups (P=0.697).
Conclusion
The therapeutic efficacy of the mEpley-PS was comparable to that of the standard mEpley. The use of the pillow modification may be an excellent alternative if a patient cannot tolerate the head-hanging position, and it is helpful for patients who have anxiety about the head-hanging position. The mEpley-PS can be performed on a bed with or without a headboard. It is both a patient-friendly and a clinician-friendly maneuver.
DOI: 10.21053/ceo.2019.01830
PubMed: 32279471
Affiliations:
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and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.</nlm:affiliation><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon</wicri:regionArea><wicri:noRegion>Incheon</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Dong Hee" sort="Lee, Dong Hee" uniqKey="Lee D" first="Dong-Hee" last="Lee">Dong-Hee Lee</name><affiliation wicri:level="1"><nlm:affiliation>Department of Otorhinolaryngology-Head and Neck Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea.</nlm:affiliation><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Otorhinolaryngology-Head and Neck Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 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Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon</wicri:regionArea><wicri:noRegion>Incheon</wicri:noRegion></affiliation></author><author><name sortKey="Jeon, Eun Ju" sort="Jeon, Eun Ju" uniqKey="Jeon E" first="Eun-Ju" last="Jeon">Eun-Ju Jeon</name><affiliation wicri:level="1"><nlm:affiliation>Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.</nlm:affiliation><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon</wicri:regionArea><wicri:noRegion>Incheon</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Dong Hee" sort="Lee, Dong Hee" uniqKey="Lee D" first="Dong-Hee" last="Lee">Dong-Hee Lee</name><affiliation wicri:level="1"><nlm:affiliation>Department of Otorhinolaryngology-Head and Neck Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea.</nlm:affiliation><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Otorhinolaryngology-Head and Neck Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu</wicri:regionArea><wicri:noRegion>Uijeongbu</wicri:noRegion></affiliation></author><author><name sortKey="Seo, Jae Hyun" sort="Seo, Jae Hyun" uniqKey="Seo J" first="Jae-Hyun" last="Seo">Jae-Hyun Seo</name><affiliation wicri:level="3"><nlm:affiliation>Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.</nlm:affiliation><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author></analytic><series><title level="j">Clinical and experimental otorhinolaryngology</title><idno type="ISSN">1976-8710</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>Objectives</b></p><p>Canalolithiasis of the posterior semicircular canal (PC) is the most common reason for benign paroxysmal positional vertigo (BPPV). If a patient is diagnosed with PC-BPPV through the Dix-Hallpike test, the modified Epley maneuver (mEpley) is used as the gold standard treatment. To reduce the discomfort of the standard mEpley, we proposed placing a pillow under the shoulders during this therapeutic maneuver. The purpose of this study was to determine whether the therapeutic efficacy of the mEpley with a pillow under the shoulders (mEpley-PS) was comparable to that of the standard mEpley.</p></div><div type="abstract" xml:lang="en"><p><b>Methods</b></p><p>A randomized controlled study at three academic referral hospitals was conducted in compliance with the CONSORT statement. Patients who were diagnosed with PC-BPPV through the Dix-Hallpike test were randomly assigned to groups A or B. Patients in groups A and B were treated with the standard mEpley and mEpley-PS, respectively. The resolution of vertigo and nystagmus on the Dix-Hallpike test at a 1-week follow-up after treatment was the main outcome measurement to assess the efficacy of treatment.</p></div><div type="abstract" xml:lang="en"><p><b>Results</b></p><p>Forty-one patients diagnosed with PC-BPPV were enrolled in this study. Twenty-one patients were assigned to group A and 20 were assigned to group B. The success rate at 1 week after treatment was 85.7% in group A and 80.0% in group B. There was no statistically significant difference between the two groups (P=0.697).</p></div><div type="abstract" xml:lang="en"><p><b>Conclusion</b></p><p>The therapeutic efficacy of the mEpley-PS was comparable to that of the standard mEpley. The use of the pillow modification may be an excellent alternative if a patient cannot tolerate the head-hanging position, and it is helpful for patients who have anxiety about the head-hanging position. The mEpley-PS can be performed on a bed with or without a headboard. It is both a patient-friendly and a clinician-friendly maneuver.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32279471</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>28</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">1976-8710</ISSN><JournalIssue CitedMedium="Print"><PubDate><Year>2020</Year><Month>Apr</Month><Day>13</Day></PubDate></JournalIssue><Title>Clinical and experimental otorhinolaryngology</Title><ISOAbbreviation>Clin Exp Otorhinolaryngol</ISOAbbreviation></Journal><ArticleTitle>Therapeutic Efficacy of the Modified Epley Maneuver With a Pillow Under the Shoulders.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.21053/ceo.2019.01830</ELocationID><Abstract><AbstractText Label="Objectives" NlmCategory="UNASSIGNED">Canalolithiasis of the posterior semicircular canal (PC) is the most common reason for benign paroxysmal positional vertigo (BPPV). If a patient is diagnosed with PC-BPPV through the Dix-Hallpike test, the modified Epley maneuver (mEpley) is used as the gold standard treatment. To reduce the discomfort of the standard mEpley, we proposed placing a pillow under the shoulders during this therapeutic maneuver. The purpose of this study was to determine whether the therapeutic efficacy of the mEpley with a pillow under the shoulders (mEpley-PS) was comparable to that of the standard mEpley.</AbstractText><AbstractText Label="Methods" NlmCategory="UNASSIGNED">A randomized controlled study at three academic referral hospitals was conducted in compliance with the CONSORT statement. Patients who were diagnosed with PC-BPPV through the Dix-Hallpike test were randomly assigned to groups A or B. Patients in groups A and B were treated with the standard mEpley and mEpley-PS, respectively. The resolution of vertigo and nystagmus on the Dix-Hallpike test at a 1-week follow-up after treatment was the main outcome measurement to assess the efficacy of treatment.</AbstractText><AbstractText Label="Results" NlmCategory="UNASSIGNED">Forty-one patients diagnosed with PC-BPPV were enrolled in this study. Twenty-one patients were assigned to group A and 20 were assigned to group B. The success rate at 1 week after treatment was 85.7% in group A and 80.0% in group B. There was no statistically significant difference between the two groups (P=0.697).</AbstractText><AbstractText Label="Conclusion" NlmCategory="UNASSIGNED">The therapeutic efficacy of the mEpley-PS was comparable to that of the standard mEpley. The use of the pillow modification may be an excellent alternative if a patient cannot tolerate the head-hanging position, and it is helpful for patients who have anxiety about the head-hanging position. The mEpley-PS can be performed on a bed with or without a headboard. It is both a patient-friendly and a clinician-friendly maneuver.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lee</LastName><ForeName>Hyun Jin</ForeName><Initials>HJ</Initials><AffiliationInfo><Affiliation>Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jeon</LastName><ForeName>Eun-Ju</ForeName><Initials>EJ</Initials><AffiliationInfo><Affiliation>Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lee</LastName><ForeName>Dong-Hee</ForeName><Initials>DH</Initials><AffiliationInfo><Affiliation>Department of Otorhinolaryngology-Head and Neck Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Seo</LastName><ForeName>Jae-Hyun</ForeName><Initials>JH</Initials><AffiliationInfo><Affiliation>Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>04</Month><Day>13</Day></ArticleDate></Article><MedlineJournalInfo><Country>Korea (South)</Country><MedlineTA>Clin Exp Otorhinolaryngol</MedlineTA><NlmUniqueID>101474010</NlmUniqueID><ISSNLinking>1976-8710</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Benign Paroxysmal Positional Vertigo</Keyword><Keyword MajorTopicYN="N">Epley Maneuver</Keyword><Keyword MajorTopicYN="N">Semicircular Canals</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>11</Month><Day>08</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2019</Year><Month>12</Month><Day>06</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>4</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>4</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>4</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32279471</ArticleId><ArticleId IdType="pii">ceo.2019.01830</ArticleId><ArticleId IdType="doi">10.21053/ceo.2019.01830</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Corée du Sud</li></country><region><li>Région capitale de Séoul</li></region><settlement><li>Séoul</li></settlement></list><tree><country name="Corée du Sud"><noRegion><name sortKey="Lee, Hyun Jin" sort="Lee, Hyun Jin" uniqKey="Lee H" first="Hyun Jin" last="Lee">Hyun Jin Lee</name></noRegion><name sortKey="Jeon, Eun Ju" sort="Jeon, Eun Ju" uniqKey="Jeon E" first="Eun-Ju" last="Jeon">Eun-Ju Jeon</name><name sortKey="Lee, Dong Hee" sort="Lee, Dong Hee" uniqKey="Lee D" first="Dong-Hee" last="Lee">Dong-Hee Lee</name><name sortKey="Seo, Jae Hyun" sort="Seo, Jae Hyun" uniqKey="Seo J" first="Jae-Hyun" last="Seo">Jae-Hyun Seo</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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