15 W. Dry Creek Circle 6169 S. Balsam Way; Suite 290
Littleton, CO 80120-4427 Littleton, Colorado 80123
Phone: (303) 798-1309 Fax: (303) 798-2319
Ear, Nose & Throat Center
Specialists of the Ear, Nose and Throat / Head and Neck Surgery / Facial Plastic Surgery
Evaluation of Dizziness & Vestibular Disorders
For more information see us at our web site ! http://www.ENT Center.Net
OFFICE TREATMENT OF BPPV
The treatments aim to dump debris out of the back part of the canal. There are two treatments of BPPV that are usually performed in the doctor's office. Both treatments are very effective, with roughly an 80% cure rate, according to a study by Herdman and others (1993). The maneuvers are named after their inventors. They are both intended to move debris or "ear rocks" out of the sensitive back part of the ear (posterior canal) to a less sensitive location. Both maneuvers take about 15 minutes to accomplish. The Semont maneuver (also called the "liberatory" maneuver) involves a procedure whereby the patient is rapidly moved from lying on one side to the other. The Epley maneuver (also called the particle repositioning, canalith repositioning procedure, and modified liberatory maneuver) involves sequential movement of the head into four positions. The recurrence rate for BPPV after these maneuvers is about 5 percent, and in some instances a second treatment may be necessary. After either of these maneuvers, you should be prepared to follow the instructions below, which are aimed at reducing the chance that debris might fall back into the sensitive back part of the ear.
INSTRUCTIONS FOR PATIENTS AFTER OFFICE TREATMENTS
(Epley or Semont maneuvers)
1. Wait for 10 minutes after the maneuver is performed before going home. This is to avoid "quick spins," or brief bursts of vertigo as debris repositions itself immediately after the maneuver. Don't drive home yourself; have someone else drive you.
2. Sleep semi-recumbent for the next two days. This means sleep with your head halfway between being flat and upright (a 45 degree angle). This is most easily done by using a recliner chair or by using pillows arranged on a couch. During the day, try to keep your head vertical. You must not go to the hairdresser or dentist. No exercise which requires head movement. When men shave under their chins, they should bend their bodies forward in order to keep their head vertical. If eyedrops are required, try to put them in without tilting the head back. Shampoo only under the shower.
3. For at least 1 week, avoid provoking head positions that might bring this on again. Use two pillows when you sleep. Avoid sleeping on the "bad" side. Don't turn your head far up or far down. Be careful to avoid head-extended position, in which you are lying on your back, especially with your head turned towards the bad side. This means be cautious at the beauty parlor, dentist's office, and if having minor surgery done. Ask them to keep you as upright as possible. If appropriate, exercises for low-back pain should be stopped for a week. No "sit-ups" for at least one week. No "crawl" swimming. (Breast stroke is OK.) Avoid far head-forward positions such as might occur in certain exercises (i.e. touching the toes).
4. At one week after treatment, put yourself in the position that usually makes you dizzy. Position yourself cautiously and under conditions in which you can't fall or hurt yourself. Let your doctor know how you did.
If a maneuver works but symptoms recur or the response is only partial, another trial of the maneuver might be advised.
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