Combined Epley and Semont Maneuver in Benign Paroxysmal Positional Vertigo

Abstract

 Introduction
 Benign paroxysmal positional vertigo is defined as a short, episodic, transient vertigo caused by changes in the position of the 
head.
 Objectives
 In this study, the effects of combined Epley and Semont maneuvers were investigated in patients with vertigo who were detected 
with some pathology in the posterior semicircular canal.
 Methods
 This prospective study, which was conducted between December 2016 and January 2018 at our clinic, included 196 patients with 
a typical history and positive Dix-Hallpike test with Videonystagmography (VNG). The patients were randomized into three 
groups as those who were subjected to the Epley, Semont or combined maneuvers. The patients were reevaluated after the first 
day, first week and first month following the maneuver. Evaluation of treatment response was based on the VNG test.
 Results
 Treatment rates of the Epley Group patients were 69.35% on the first day, 75.80% after the first week and 85.48% after the first 
month. The treatment rates of the Semont Group patients were found to be 63.26% on the first day, 75.51% after the first week 
and 81.63% after the first month. On the other hand, the treatment rates of the combined group patients were 85.88% on the 
first day, 90.58% after one week and 95.29% after one month. The treatment rate registered with the combined maneuver was 
found to be significantly higher than those in the Epley Group and the Semont Group (χ2 = 6.685, p<0.05; χ2 = 6.346, p<0.05). 
Six months after recovery, recurrence was registered in four patients in the Epley Group (6.4%) and five patients in the Semont 
Group (10.2%). 
Conclusion
 The results show that utilization of combined maneuvers in our study increased the success rate.