More than 394 patients have been reported in blinded studies comparing the Epley or Semont maneuver to either placebo or medical treatment. The results are clearly in favor of these maneuvers. The median response in treated patients was 81%, compared to 37.% in placebo or untreated subjects. The few instances where the Epley or Semont results were not compelling (e.g. Blakely et al, 1994), may have been instances where technique was not perfected.
Study
treated
Response
controls
Response
total
394
percent
201
percent
Response
median
81
37.5
Froehling, Bowen et al. 2000
50
67
26
38
67% vs. 38% at 2 weeks
Li 1995
37
70
23
0
70% vs 0% at 1 week
Lynn, Pool et al. 1995
36
88
18
27
88% vs. 27% at 1 month
Blakley 1994
38
86
19
94
No statistical difference at 1 month
Wolf, Hertanu et al. 1999
41
75
10
50
75% response vs. 50% at 1 week
Fujino, Tokumasu et al. 1994
61
62
20
30
62% response vs. 30% at 2 weeks (p<.05)
Sherman and Massoud 2001
71
81
25
60
81% response v.s. 60% at 2 weeks
(no statistical difference)
Simhadri et al (2003)
20
95
20
5
More recurrence in controls
Salvanelli et al, 2003
40
92.5
40
37.5
Semont maneuver
References
Blakley, B. W. (1994). "A randomized, controlled assessment of the canalith repositioning maneuver." Otolaryngol Head Neck Surg110(4): 391-6.
(Fujino, Tokumasu et al. 1994; Li 1995; Lynn, Pool et al. 1995; Wolf, Boyev et al. 1999; Froehling, Bowen et al. 2000; Sherman and Massoud 2001; Salvinelli, Casale et al. 2003; Simhadri, Panda et al. 2003) .
Froehling, D. A., J. M. Bowen, et al. (2000). "The canalith repositioning procedure for the treatment of benign paroxysmal positional vertigo: a randomized controlled trial." Mayo Clin Proc75(7): 695-700.
Fujino, A., K. Tokumasu, et al. (1994). "Vestibular training for benign paroxysmal positional vertigo. Its efficacy in comparison with antivertigo drugs." Arch Otolaryngol Head Neck Surg120(5): 497-504.
Li, J. C. (1995). "Mastoid oscillation: a critical factor for success in canalith repositioning procedure." Otolaryngol Head Neck Surg112(6): 670-5.
Lynn, S., A. Pool, et al. (1995). "Randomized trial of the canalith repositioning procedure." Otolaryngol Head Neck Surg113(6): 712-20.
Salvinelli, F., M. Casale, et al. (2003). "Benign paroxysmal positional vertigo: a comparative prospective study on the efficacy of Semont's maneuver and no treatment strategy." Clin Ter154(1): 7-11.
Sherman, D. and E. A. Massoud (2001). "Treatment outcomes of benign paroxysmal positional vertigo." J Otolaryngol30(5): 295-9.
Simhadri, S., N. Panda, et al. (2003). "Efficacy of particle repositioning maneuver in BPPV: a prospective study." Am J Otolaryngol24(6): 355-60.
Wolf, J. S., K. P. Boyev, et al. (1999). "Success of the modified Epley maneuver in treating benign paroxysmal positional vertigo." Laryngoscope109(6): 900-3.
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January 21, 2008
