Abstract：
BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is one of the commonest causes of peripheral vertigo. It is treated with various canalolith repositioning manoeuvres by changing the head positions to allow the otoconial debris to fall back from the affected canal back to the utricle. The present study has compared the rate of recovery of vertigo with modified Epley\'s manoeuvres as compared to Semont\'s manoeuvre in patients with posterior canal BPPV.
METHODS: One hundred and seventy patients diagnosed by positive Dix-Hallpike test as posterior canal BPPV were included in this clinical trial. Subjective analysis of vertigo was done using visual analogue scale. 85 patients each were recruited in two arms by simple randomization using lottery method. Modified Epley\'s manoeuvre was administered to one group and Semont\'s manoeuvre to the other. They were recalled after 2 weeks for clinical assessment with repeat Dix-Hallpike and VAS.
RESULTS: Repeat Dix-Hallpike manoeuvres after two weeks revealed that 95.3 and 90.6% patients improved in Modified Epley\'s and Semont\'s group, respectively. After the second manoeuvre, the resolution rate was significantly higher in Semont\'s manoeuvre 100% (8 out of 8 patients), as compared to 25% (1 out of 4 patients) in Modified Epley\'s manoeuvre. Comparison of the mean values of VAS day 0 and VAS 2 weeks has been found to be statistically significant (p value of < 0.001).
CONCLUSIONS: Both Epley\'s and Semont\'s manoeuvre are equally efficacious in treatment of BPPV. However, use of Semont\'s manoeuvre required fewer repeat manoeuvres for complete resolution of symptoms in patients. The Semont\'s manoeuvre is also comparatively easier to perform with less number of position changes, takes less time, and has no requirement of post-manoeuvre mobility restrictions. Hence, it is recommended that Semont\'s manoeuvre can be routinely used for the management of PC BPPV especially in older population and patients with spinal problems.
METHODS: One hundred and seventy patients diagnosed by positive Dix-Hallpike test as posterior canal BPPV were included in this clinical trial. Subjective analysis of vertigo was done using visual analogue scale. 85 patients each were recruited in two arms by simple randomization using lottery method. Modified Epley\'s manoeuvre was administered to one group and Semont\'s manoeuvre to the other. They were recalled after 2 weeks for clinical assessment with repeat Dix-Hallpike and VAS.
RESULTS: Repeat Dix-Hallpike manoeuvres after two weeks revealed that 95.3 and 90.6% patients improved in Modified Epley\'s and Semont\'s group, respectively. After the second manoeuvre, the resolution rate was significantly higher in Semont\'s manoeuvre 100% (8 out of 8 patients), as compared to 25% (1 out of 4 patients) in Modified Epley\'s manoeuvre. Comparison of the mean values of VAS day 0 and VAS 2 weeks has been found to be statistically significant (p value of < 0.001).
CONCLUSIONS: Both Epley\'s and Semont\'s manoeuvre are equally efficacious in treatment of BPPV. However, use of Semont\'s manoeuvre required fewer repeat manoeuvres for complete resolution of symptoms in patients. The Semont\'s manoeuvre is also comparatively easier to perform with less number of position changes, takes less time, and has no requirement of post-manoeuvre mobility restrictions. Hence, it is recommended that Semont\'s manoeuvre can be routinely used for the management of PC BPPV especially in older population and patients with spinal problems.
摘要：
背景：良性阵发性位置性眩晕（BPPV）是外周性眩晕的最常见原因之一。通过改变头部位置以使耳科碎屑从受影响的运河回落到岩心，可以进行各种耳石重新定位操作。本研究比较了后管BPPV患者采用改良的Epley动作与Semont动作的眩晕恢复率。
方法：本临床试验包括通过Dix-Hallpike试验阳性诊断为后管BPPV的一百七十例患者。使用视觉模拟量表对眩晕进行主观分析。使用抽奖方法通过简单随机分组将85名患者分为两组。修改后的Epley的动作被分配给一组，Semont的动作被分配给另一组。2周后，他们被召回，以重复Dix-Hallpike和VAS进行临床评估。
结果：两周后重复Dix-Hallpike动作，发现改良Epley和Semont组95.3％和90.6％的患者有所改善，分别。在第二次演习之后，在Semont的操作中，分辨率明显高于100%(8/8患者)，相比之下，改良Epley的策略为25%(4例患者中有1例)。已发现第0天的VAS和第2周的VAS的平均值的比较具有统计学显著性(P值<0.001)。
结论：Epley和Semont的策略在治疗BPPV方面同样有效。然而,使用Semont的动作需要较少的重复动作才能完全缓解患者的症状。Semont的操作也相对更容易执行，位置变化较少，需要更少的时间，并且没有操纵后行动限制的要求。因此，建议Semont的操作可常规用于PCBPPV的治疗，尤其是在老年人和有脊柱问题的患者中。
方法：本临床试验包括通过Dix-Hallpike试验阳性诊断为后管BPPV的一百七十例患者。使用视觉模拟量表对眩晕进行主观分析。使用抽奖方法通过简单随机分组将85名患者分为两组。修改后的Epley的动作被分配给一组，Semont的动作被分配给另一组。2周后，他们被召回，以重复Dix-Hallpike和VAS进行临床评估。
结果：两周后重复Dix-Hallpike动作，发现改良Epley和Semont组95.3％和90.6％的患者有所改善，分别。在第二次演习之后，在Semont的操作中，分辨率明显高于100%(8/8患者)，相比之下，改良Epley的策略为25%(4例患者中有1例)。已发现第0天的VAS和第2周的VAS的平均值的比较具有统计学显著性(P值<0.001)。
结论：Epley和Semont的策略在治疗BPPV方面同样有效。然而,使用Semont的动作需要较少的重复动作才能完全缓解患者的症状。Semont的操作也相对更容易执行，位置变化较少，需要更少的时间，并且没有操纵后行动限制的要求。因此，建议Semont的操作可常规用于PCBPPV的治疗，尤其是在老年人和有脊柱问题的患者中。
