[Complementary self-treatment for posterior canal benign paroxysmal positional vertigo].

OBJECTIVE: To examine the value of self-treatment for Posterior canal benign paroxysmal positional vertigo (PC-BPPV). The treatment effect was compared between patients treated with modified Epley in outpatient clinic combined with self treatment at home and patients treated by modified Epley alone. METHOD: A randomized controlled trial were carried out in the Department of Otolaryngology Head and Neck Surgery, the Affiliated Sixth People's Hospital of Shanghai Jiao Tong University from December 2012 to May 2013. 147 out of 150 patients with unilateral idiopathic BPPV-PSC were enrolled in follow-up. Among which, 73 patients were allocated in modified Epley-alone group and 74 were allocated in slef-treatment group. RESULT: The success rate was 53.4% in modified Epley-alone group vs 83.8% in self-treatment group (P < 0.01) after 1 week treatment. In the modified Epley-alone group,the success rate of hand repositioning group and chair-assisted repositioning group was 45.9% vs 61.1% (P > 0.05), the risk rate was 0.752, 95% CI (0.486 - 1.163). In the self-treatment group, the success rate of hand repositioning group and chair-assisted repositioning group was 87.5% vs 81.0% (P > 0.05), the risk rate was 1.081, 95% CI (0.888-1.316). Incidence rate of serious complications was 0% in the modified Epley-alone group and 1.3% in the self-treatment group (P > 0.05). CONCLUSION: Complementary self-treatment with modified Epley maneuver treated PC-BPPV sooner and more effectively, Compared with modified Epley maneuver alone. And its incidence rate of serious complications didn't increase. Chair-assisted repositioning showed better result than hand repositioning alone, and self-treatment at home can reduce the effect of the gap. We found that complementary self-treatment with modified Epley maneuver had more benefits for patients with PC-BPPV.