TY - JOUR
T1 - Rapid Systematic Review of the Epley Maneuver for Treating Posterior Canal Benign Paroxysmal Positional Vertigo
AU - van Duijn, Jeroen G
AU - Isfordink, Liz M
AU - Nij Bijvank, Jenny A
AU - Stapper, Carlijne W
AU - van Vuren, Annelies J
AU - Wegner, Inge
AU - Kortekaas, Marlous F
AU - Grolman, Wilko
N1 - © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.
PY - 2014/6
Y1 - 2014/6
N2 - OBJECTIVE: The aim of this study was to compare watchful waiting to the Epley maneuver as a management option for patients with posterior canal benign paroxysmal positional vertigo (p-BPPV) regarding symptom relief.DATA SOURCES: PubMed, Embase, and The Cochrane Library.METHODS: A systematic search was conducted. Studies reporting original study data were included. Relevance and risk of bias (RoB) of the selected articles were assessed. Studies with low relevance, high RoB, or both were excluded. Absolute risk differences and their 95% confidence intervals (CIs) were extracted for the included studies.RESULTS: A total of 1448 unique studies were retrieved. Eight of these satisfied the eligibility criteria. At 1-week follow-up, all included studies reported a clinically relevant effect in favor of the Epley maneuver regarding symptom relief (absolute risk differences ranging from 20% [95% CI, 5%-37%] to 59% [95% CI, 32%-76%]) or conversion to a negative Dix-Hallpike (absolute risk differences ranging from 17% [95% CI, -5%-37%] to 64% [95% CI, 29%-79%]). At 1-month follow-up, the results of the included studies diverged further. Absolute risk differences ranged from 6% (95% CI, -24%-35%) more symptom relief in favor of watchful waiting to 79% (95% CI, 56%-88%) in favor of the Epley maneuver.CONCLUSION AND RECOMMENDATIONS: All data of the selected studies show a benefit in favor of the Epley maneuver at 1-week follow-up in the management of p-BPPV. The Epley maneuver should be considered in all patients with p-BPPV.
AB - OBJECTIVE: The aim of this study was to compare watchful waiting to the Epley maneuver as a management option for patients with posterior canal benign paroxysmal positional vertigo (p-BPPV) regarding symptom relief.DATA SOURCES: PubMed, Embase, and The Cochrane Library.METHODS: A systematic search was conducted. Studies reporting original study data were included. Relevance and risk of bias (RoB) of the selected articles were assessed. Studies with low relevance, high RoB, or both were excluded. Absolute risk differences and their 95% confidence intervals (CIs) were extracted for the included studies.RESULTS: A total of 1448 unique studies were retrieved. Eight of these satisfied the eligibility criteria. At 1-week follow-up, all included studies reported a clinically relevant effect in favor of the Epley maneuver regarding symptom relief (absolute risk differences ranging from 20% [95% CI, 5%-37%] to 59% [95% CI, 32%-76%]) or conversion to a negative Dix-Hallpike (absolute risk differences ranging from 17% [95% CI, -5%-37%] to 64% [95% CI, 29%-79%]). At 1-month follow-up, the results of the included studies diverged further. Absolute risk differences ranged from 6% (95% CI, -24%-35%) more symptom relief in favor of watchful waiting to 79% (95% CI, 56%-88%) in favor of the Epley maneuver.CONCLUSION AND RECOMMENDATIONS: All data of the selected studies show a benefit in favor of the Epley maneuver at 1-week follow-up in the management of p-BPPV. The Epley maneuver should be considered in all patients with p-BPPV.
KW - Benign Paroxysmal Positional Vertigo/therapy
KW - Humans
KW - Musculoskeletal Manipulations
KW - Watchful Waiting
U2 - 10.1177/0194599814527732
DO - 10.1177/0194599814527732
M3 - Review article
C2 - 24687942
SN - 0194-5998
VL - 150
SP - 925
EP - 932
JO - Otolaryngology and Head and Neck Surgery
JF - Otolaryngology and Head and Neck Surgery
IS - 6
ER -