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jsmc-10083


EFFECTIVENESS OF CINNARIZINE AND/OR POSTURAL RESTRICTION AS AN ADJUVANT MEASURES ON THE THERAPEUTIC EFFECTS OF CANALITH REPOSITIONING PROCEDURE IN TREATING UNILATERAL PC-BPPV


Sherko Saeed Fathullah Zmnako *


* Department of Surgery, School of Medicine, Faculty of Medical Sciences, University of Sulaimani.


Submitted: 15/4/2015; Accepted: 30/8/2015


ABSTRACT


Background 

Posterior Canal Benign Paroxysmal Positional Vertigo (PC-BPPV) is by far the most common cause of vertigo, to establish the diagnosis the Dix-Hallpike maneuver (DX) is the definitive part of the physical examination.First-line therapy is organized around Canalith Repositioning Procedure (CRP). Further treatment options include: many otolaryngologists had routinely prescribed post-maneuver postural restriction and/or vestibular suppressants the latter as an adjuvant treatment for this disorder.

Patients and Methods

A prospective double blinded randomized interventional controlled study conducted on 109 patients diagnosed as having canalithiasis unilateral PC-BPPV. Enrolled patients were received CRP as an initial standard treatment then randomly assigned in to four groups of treatments. Two different scales of vertigo symptoms assessment were used before and after the procedure: 1- Dizziness Handicap Inventory (DHI). 2- Vertigo Symptom Scale - Short Form (SF).

Results

DHI 1, SF 1 (1 week post-CRP) and DHI 3, SF 3 (3 months post-CRP) didn’t show significant differences across the groups, P value: 0.487, 0.933, 0.979 and 0.145 respectively (P > 0.05). The mean ranks of DHI 2 and SF 2 (1month post-CRP) in G3 in compare with other groups are lower in both scales. The mean ranks of DHI
2 in Groups 1, 2, 3 and 4 are 59.78, 53.33, 29.39 and 42.1 respectively and in addition these ranks for SF 2 are 53.5, 57.07, 29.95 and 45.48 respectively.

Conclusion

Cinnarizine as adjuvant therapy didn’t enhance the therapeutic effect of CRP. Adjuvant postural restriction enhances the therapeutic effect of CRP by facilitating symptoms resolution within one month (medium term effect).

KEYWORDS

Posterior canal BPPV, Canalith Repositioning Procedure, Cinnarizine, Postural restriction, Vestibular suppressants.