Hiệu quả các nghiệm pháp điều trị chóng mặt tư thế kịch phát lành tính ống bán khuyên sau

Benign Paroxysmal Positional Vertigo (BPPV) of the posterior canal (PC-BPPV) is the most prevalent cause of peripheral vestibular vertigo, significantly impacting patients' quality of life. Characterized by sudden, intense, and short-duration vertigo attacks triggered by head position changes, BPPV requires effective and safe therapeutic interventions. Historically, various repositioning maneuvers like the Epley maneuver and Semont maneuver have been developed and refined to address the underlying mechanism of displaced otoconia. While these classical maneuvers are widely adopted, new variations have emerged to overcome limitations or enhance efficacy. This paper aims to evaluate the current evidence on the effectiveness of different repositioning maneuvers for PC-BPPV, providing a comprehensive overview of their therapeutic outcomes.

Medical professionals, researchers, and students in otolaryngology, neurology, physical therapy, and general medicine interested in the management of benign paroxysmal positional vertigo.

This scoping review systematically evaluated the effectiveness of various repositioning maneuvers in treating posterior canal Benign Paroxysmal Positional Vertigo (PC-BPPV). The study meticulously compiled data from 25 relevant articles identified through searches across major scientific databases including PubMed, Google Scholar, and the Hanoi Medical University library. The findings highlight that classical techniques, specifically the Epley maneuver and the Semont maneuver, remain foundational and widely utilized, demonstrating high therapeutic efficacy with average cure rates of 77% and 76%, respectively. Furthermore, the review underscores the promising outcomes of newer, modified repositioning maneuvers such as the Gans maneuver and modified Epley maneuver, which reported even higher average cure rates of 87% and 89%. It was observed that a single maneuver application generally yields lower effectiveness compared to a complete treatment course. The implication of these findings is significant: while Epley and Semont maneuvers are highly effective, alternative and modified repositioning maneuvers show comparable or even superior efficacy, particularly in cases where contraindications exist, such as cervical or lumbar spine diseases. This suggests a broader applicability of repositioning strategies. The study recommends re-evaluation after initial treatment and, if necessary, multiple sessions to optimize therapeutic effectiveness, thus guiding clinical practice towards more personalized and adaptive management of PC-BPPV.