Gufoni法治疗向地性眼震型水平半规管良性阵发性位置性眩晕效果分析
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摘要
目的探讨Gufoni法治疗向地性眼震型水平半规管良性阵发性位置性眩晕的有效性。方法选择2016年1-12月共87例向地性眼震型水平半规管良性阵发性位置性眩晕患者,均采用Gufoni法复位2次,次日复查,仍存在向地性眼震和眩晕者,再次行Gufoni法复位2次,30 min后复查。结果87例患者经Gufoni法复位后,次日复查有效率为71.26%(62/87),再次复位后有效率为86.21%(75/87)。12例无效患者中8例仍存在向地性眼震,予强迫健侧卧位法治愈;4例转变为后半规管良性阵发性位置性眩晕,予Epley法复位治愈。结论 Gufoni法可以作为治疗向地性眼震型水平半规管良性阵发性位置性眩晕的有效方法,且多次重复可以提高疗效。
Objective To investigate the efficacy of Gufoni maneuver for treating geotropicnystagmus horizontal semicircular canal benign paroxysmal positional vertigo(BPPV). Methods Weretrospectively analyzed 87 patients diagnosed as geotropic nystagmus horizontal semicircular canal BPPVfrom January to December 2016. All patients were treated by Gufoni maneuver twice and examined on thenext day to access the status of BPPV. Patients still with geotropic nystagmus or dizziness were treated byGufoni maneuver twice again and examined after 30 min. The effect was assessed by "Diagnosis basis andcurative effect appraisal of benign paroxysmal positional vertigo(2006, Guiyang)". Results The successrate of first treatment by Gufoni maneuver achieved to 71.26%(62/87) and increased to 86.21%(75/87)after the second treatment. Among these patients, 12 patients failed to recover, 8 of whom were treated byforced prolonged position(FPP) and recovered after one week, and 4 of whom turned to be posteriorsemicircular canal BPPV and were treated by Epley maneuver successfully. Conclusions Gufonimaneuver is proved to be a good treatment for geotropic nystagmus horizontal semicircular canal BPPV andthe efficacy increases after repeated treatment.
Objective To investigate the efficacy of Gufoni maneuver for treating geotropicnystagmus horizontal semicircular canal benign paroxysmal positional vertigo(BPPV). Methods Weretrospectively analyzed 87 patients diagnosed as geotropic nystagmus horizontal semicircular canal BPPVfrom January to December 2016. All patients were treated by Gufoni maneuver twice and examined on thenext day to access the status of BPPV. Patients still with geotropic nystagmus or dizziness were treated byGufoni maneuver twice again and examined after 30 min. The effect was assessed by "Diagnosis basis andcurative effect appraisal of benign paroxysmal positional vertigo(2006, Guiyang)". Results The successrate of first treatment by Gufoni maneuver achieved to 71.26%(62/87) and increased to 86.21%(75/87)after the second treatment. Among these patients, 12 patients failed to recover, 8 of whom were treated byforced prolonged position(FPP) and recovered after one week, and 4 of whom turned to be posteriorsemicircular canal BPPV and were treated by Epley maneuver successfully. Conclusions Gufonimaneuver is proved to be a good treatment for geotropic nystagmus horizontal semicircular canal BPPV andthe efficacy increases after repeated treatment.
引文
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[3]Escher A,Ruffieux C,Maire R.Efficacy of the barbecue manoeuvre in benign paroxysmal vertigo of the horizontal canal[J].Eur Arch Otorhinolaryngol,2007,264:1239-1241.
[4]Nuti D,Agus G,Barbieri MT,Passali D.The management of horizontal-canal paroxysmal positional vertigo[J].Acta Otolaryngol,1998,118:455-460.
[5]Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery,Otorhinolaryngology Branch of Chinese Medical Association.Diagnosis basis and curative effect appraisal of benign paroxysmal positional vertigo(2006,Guiyang)[J].Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi,2007,42:163-164[.中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉科学分会.良性阵发性位置性眩晕的诊断依据和疗效评估(2006年,贵阳)[J].中华耳鼻咽喉头颈外科杂志,2007,42:163-164.]
[6]Choung YH,Shin YR,Kahng H,Park K,Choi SJ.'Bow and lean test'to determine the affected ear of horizontal canal benign paroxysmal positional vertigo[J].Laryngoscope,2006,116:1776-1781.
[7]Nuti D,Vannueehi P,Pagnini P.Benign paroxysmal positional vertigo of the horizontal canal:a form of eanalolithiasis with variable clinical features[J].J Vestib Res,1996,6:173-184.
[8]McClure JA.Horizontal canal BPV[J].J Otolarynogol,1985,14:30-35.
[9]Li J,Zou S,Tian S.A prospective randomized controlled study of Li quick repositioning maneuver for geotropic horizontal canal BPPV[J].Acta Otolaryngol,2018,138:779-784.
[10]Casani AP,Vannucci G,Fattori B,Berrettini S.The treatment of horizontal canal positional vertigo:our experience in 66 cases[J].Laryngoscope,2002,112:172-178.
[11]Korres S,Riga MG,Xenellis J,Korres GS,Danielides V.Treatment of the horizontal semicircular canal canalithiasis:pros and cons of the repositioning maneuvers in a clinical study and critical review of the literature[J].Otol Neurotol,2011,32:1302-1308.
[12]Kim JS,Oh SY,Lee SH,Kang JH,Kim DU,Jeong SH,Choi KD,Moon IS,Kim BK,Kim HJ.Randomized clinical trial for geotropic horizontal canal benign paroxysmal positional vertigo[J].Neurology,2012,78:159-166.
[13]Van den Broek EM,van der Zaag-Loonen HJ,Bruintjes TD.Systematic review:efficacy of Gufoni maneuver for treatment of lateral canal benign paroxysmal positional vertigo with geotropic nystagmus[J].Otolaryngol Head Neck Surg,2014,150:933-938.
[14]MandalàM,Pepponi E,Santoro GP,Cambi J,Casani A,Faralli M,Giannoni B,Gufoni M,Marcelli V,Trabalzini F,Vannucchi P,Nuti D.Double-blind randomized trial on the efficacy of the Gufoni maneuver for treatment of lateral canal BPPV[J].Laryngoscope,2013,123:1782-1786.
[15]Kim HA,Park SW,Kim J,Kang BG,Lee J,Han BI,Seok JI,Chung EJ,Kim J,Lee H.Efficacy of mastoid oscillation and the Gufoni maneuver for treating apogeotropic horizontal benign positional vertigo:a randomized controlled study[J].J Neurol,2017,264:848-855.
[16]Casani AP,Nacci A,Dallan I,Panicucci E,Gufoni M,SellariFranceschini S.Horizontal semicircular canal benign paroxysmal positional vertigo:effectiveness of two different methods of treatmen[tJ].Audiol Neurootol,2011,16:175-184.
[2]Imai T,Ito M,Takeda N,Uno A,Matsunaga T,Sekine K,Kubo T.Natural course of the remission of vertigo in patients with benign paroxysmal positional vertigo[J].Neurology,2005,64:920-921.
[3]Escher A,Ruffieux C,Maire R.Efficacy of the barbecue manoeuvre in benign paroxysmal vertigo of the horizontal canal[J].Eur Arch Otorhinolaryngol,2007,264:1239-1241.
[4]Nuti D,Agus G,Barbieri MT,Passali D.The management of horizontal-canal paroxysmal positional vertigo[J].Acta Otolaryngol,1998,118:455-460.
[5]Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery,Otorhinolaryngology Branch of Chinese Medical Association.Diagnosis basis and curative effect appraisal of benign paroxysmal positional vertigo(2006,Guiyang)[J].Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi,2007,42:163-164[.中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉科学分会.良性阵发性位置性眩晕的诊断依据和疗效评估(2006年,贵阳)[J].中华耳鼻咽喉头颈外科杂志,2007,42:163-164.]
[6]Choung YH,Shin YR,Kahng H,Park K,Choi SJ.'Bow and lean test'to determine the affected ear of horizontal canal benign paroxysmal positional vertigo[J].Laryngoscope,2006,116:1776-1781.
[7]Nuti D,Vannueehi P,Pagnini P.Benign paroxysmal positional vertigo of the horizontal canal:a form of eanalolithiasis with variable clinical features[J].J Vestib Res,1996,6:173-184.
[8]McClure JA.Horizontal canal BPV[J].J Otolarynogol,1985,14:30-35.
[9]Li J,Zou S,Tian S.A prospective randomized controlled study of Li quick repositioning maneuver for geotropic horizontal canal BPPV[J].Acta Otolaryngol,2018,138:779-784.
[10]Casani AP,Vannucci G,Fattori B,Berrettini S.The treatment of horizontal canal positional vertigo:our experience in 66 cases[J].Laryngoscope,2002,112:172-178.
[11]Korres S,Riga MG,Xenellis J,Korres GS,Danielides V.Treatment of the horizontal semicircular canal canalithiasis:pros and cons of the repositioning maneuvers in a clinical study and critical review of the literature[J].Otol Neurotol,2011,32:1302-1308.
[12]Kim JS,Oh SY,Lee SH,Kang JH,Kim DU,Jeong SH,Choi KD,Moon IS,Kim BK,Kim HJ.Randomized clinical trial for geotropic horizontal canal benign paroxysmal positional vertigo[J].Neurology,2012,78:159-166.
[13]Van den Broek EM,van der Zaag-Loonen HJ,Bruintjes TD.Systematic review:efficacy of Gufoni maneuver for treatment of lateral canal benign paroxysmal positional vertigo with geotropic nystagmus[J].Otolaryngol Head Neck Surg,2014,150:933-938.
[14]MandalàM,Pepponi E,Santoro GP,Cambi J,Casani A,Faralli M,Giannoni B,Gufoni M,Marcelli V,Trabalzini F,Vannucchi P,Nuti D.Double-blind randomized trial on the efficacy of the Gufoni maneuver for treatment of lateral canal BPPV[J].Laryngoscope,2013,123:1782-1786.
[15]Kim HA,Park SW,Kim J,Kang BG,Lee J,Han BI,Seok JI,Chung EJ,Kim J,Lee H.Efficacy of mastoid oscillation and the Gufoni maneuver for treating apogeotropic horizontal benign positional vertigo:a randomized controlled study[J].J Neurol,2017,264:848-855.
[16]Casani AP,Nacci A,Dallan I,Panicucci E,Gufoni M,SellariFranceschini S.Horizontal semicircular canal benign paroxysmal positional vertigo:effectiveness of two different methods of treatmen[tJ].Audiol Neurootol,2011,16:175-184.