Postmaneuver restrictions in benign paroxysmal positional vertigo: An individual patient data meta-analysis
Portions of this research were presented at the 2007 AAO–HNSF Annual Meeting & OTO EXPO, Washington, DC, September 16-19, 2007.
Received 31 August 2009; received in revised form 4 September 2009; accepted 18 September 2009. published online 25 November 2009.
Abstract
Objective
Treatment of benign paroxysmal positional vertigo (BPPV) with the Epley and Semont maneuvers has been used with and without postmaneuver postural restrictions. Studies examining these restrictions have yielded differing results. This study sought to examine the studies for a more uniform conclusion.
Data Sources
Controlled studies with objective identification of unilateral posterior semicircular canal BPPV and symptom resolution were analyzed. A PubMed search identified six studies totaling 523 patients meeting all inclusion criteria.
Review Methods
Cohorts treated with and without restrictions were compared. Individual patient pooled analyses in a one-stage comparison were used for the meta-analysis.
Results
Pooled results of all restriction types showed no advantage over no restriction. Studies including each individual restriction were examined against the pooled population to look for technique differences. No restriction was found to be statistically significant.
Conclusions
The restrictions examined in controlled trials did not differ significantly in clinical outcomes, which suggests that restrictions do not appear to significantly affect the efficacy of BPPV maneuvers.
aDepartment of Otolaryngology–Head and Neck Surgery, Boston University School of Medicine, Boston, MA
bDepartment of Neurological Surgery, Boston University School of Medicine, Boston, MA
cDepartment of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
Corresponding author: Anand K. Devaiah, MD, Department of Otolaryngology–Head and Neck Surgery, Boston Medical Center, 88 East Newton St, D608 Collamore, Boston, MA 02118
Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.
ABSTRACT