THT Presentasi Unissula BPPV

8/22/2019 THT Presentasi Unissula BPPV

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Journal Reading

Tutor :dr. Tris Sudyartono, Sp.THT-KL

dr. Agus Sudarwi, Sp.THT-KL

dr. Afif Zjauhari, Sp.THT-KL

Presented By :

Dimar Kumala Puspaningrum

Dyah Carano Fitri

Sultan Agung Islamic UniversityFaculty of Medicine


2/19

Effect of the canalith repositioning

procedure on subjective visual

horizontalin patients with posterior canal benign paroxysmal

positional vertigo

SHINICHI IWASAKI, YASUHIRO CHIHARA, MUNETAKA USHIO, ATSUSHI OCHI,

TOSHIHISA MUROFUSHI & TATSUYA YAMASOBA

Department of Otolaryngology, Faculty of Medicine, University of Tokyo,

and Department of Otolaryngology, Teikyo University School of Medicine Mizonokuchi Hospital, Kawasaki, Japan


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ABSTRACT

To evaluate

the changes of subjective

visual horizontal (SVH) in

patients with p-BPPV

before and after treatment

with the canalith

repositioning procedure.

26 patients with p-BPPV

were treated with Epleys

maneuver. Baseline SVH

measurements were

taken before performingthe maneuver, just after

maneuver, and 2 weeks

after maneuver.

OBJECTIVE METHOD


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26 patients with p-BPPV,11 showed abnormal

deviation of SVH.

Just after and 2weeks

performing Epleysmaneuver, the patientswho showed an

abnormal deviationdecreased.

patients withposterior canal have

signs of

utricular dysfunction

at baseline improvesafter performing thecanalith repositioning

procedure.

RESULT CONCLUSION


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INTRODUCTION

BPPV isconsidered to be

caused by

small particlestrapped in the

semicircularcanals

The canalith

repositioningmaneuver relocates

the freefloating

particles from the

affected semicircularcanal

back into the utricle


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the results of SVH/V

in patients withBPPV have been

controversial.

that half of the

patients with BPPV

showed an abnormaldeviation of SVH/V

the timing of themeasurement of

SVH/V

Several

studies havereported that therewere no significant


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MeasurementBefore the

Dix-Hallpikemaneuver

and thecanalith

repositioningprocedure

Afterperformingthe canalith

repositioning

procedure

2 weeksafter

treatment


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Material andmethods

INCLUSION

unilateral

p-BPPV

ages ranged from 19

to 76 years

EXCLUSION

Bilateral BPPV,

previously

received Epleys

maneuver

Menieres disease,

other vestibular

diseases ,other ear

diseases.


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SUBJECTIVE VISUALHORIZONTAL

(SUBJECT)

2 weeks

post

Epley

Post-

Epley

Baseline

SUBJECTIVE VISUALHORIZONTAL

(CONTROL)

Post

Epley

Baseline


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P > 0,01

P < 0,01

R ti f bj ti i l


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Ratio of subjective visual

horizontal (SVH) in

patients with BPPV.


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DISCUSSION

Epleys

Manouver

40 % abnormal

deviation of SVH(baseline)


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Previous

Results studies

normal or slightly abnormal

SVH in

patients with BPPV

8 of 16 patients with BPPV

showed an abnormal deviation

of SVV before performing

the canalith repositioning

procedure


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dislodgement of

otoconia

posterior

semicircular

canal.

activities of the

utricular nerve

ABNORMAL DEVIATION OF SVH/V

Excitation -inhibition

head

movements

free-floating

otoconia


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Successive changes of the

mean value of SVH

(A) and 15 patients

who showed normal SVH at the baseline condition (B). Dotted lines show the upperand lower limits of normal SVH (+ 2.18 and2.18).

Positive values indicate affected side down and negative values indicate unaffected

side down.


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THE RESULT of CANALITH

REPOSITIONING PROCEDURE

NORMALABNORMAL

ABNORMAL NORMAL

20 %

73 %


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CONCLUSION

40% of patients with p-

BPPV show an

abnormal

deviation of SVH,which significantly

improved

after performing

Epleys maneuver.


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THT Presentasi Unissula BPPV

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