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Laryngoscope ; 124(10): 2400-3, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24782447

RESUMO

OBJECTIVES/HYPOTHESIS: To investigate the characteristics of residual symptoms and to evaluate the effects of adjuvant vestibular suppressants on residual symptoms after successful canalith repositioning procedures (CRPs). STUDY DESIGN: Individual randomized controlled trial. METHODS: One hundred fifty patients with idiopathic benign paroxysmal positional vertigo who achieved successful CRPs on initial visit participated in this study. Dizziness Handicap Inventory (DHI) questionnaires were completed before CRPs. All study populations were divided into three groups after successful CRPs on the initial visit day: the medication (V) group (treated with a vestibular suppressant [dimenhydrinate 50 mg per day]), the placebo (P) group, and the no medication (N) group. One week after successful CRPs, residual symptoms were checked and repeated DHI questionnaires were completed to compare residual symptoms. RESULTS: Among the 138 patients who did not show positional nystagmus at follow-up, 67 (48.5%) complained of residual symptoms. The presence of residual symptoms was more prevalent in the P and N group compared with the V group (P = .035, P = .017, respectively). The most frequent residual symptom was lightheadedness (n = 42). Moreover, in the V group, lightheadedness was significantly reduced compared with the P group (P = .029). However, in the analysis of DHI, total and subscale scores did not differ across the three groups before or after successful CRP. CONCLUSIONS: Vestibular suppressants significantly reduced residual symptoms compared to both placebo and no medication after CRP. However, there was no significant reduction in DHI score compared with the control group, suggesting that the residual symptoms could not be evaluated by DHI score alone.


Assuntos
Vertigem Posicional Paroxística Benigna/cirurgia , Dimenidrinato/administração & dosagem , Tontura/tratamento farmacológico , Nistagmo Fisiológico/fisiologia , Procedimentos Cirúrgicos Otológicos , Canais Semicirculares/cirurgia , Vestíbulo do Labirinto/efeitos dos fármacos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antieméticos/administração & dosagem , Vertigem Posicional Paroxística Benigna/complicações , Vertigem Posicional Paroxística Benigna/fisiopatologia , Tontura/etiologia , Tontura/fisiopatologia , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Posicionamento do Paciente , Complicações Pós-Operatórias , Estudos Retrospectivos , Inquéritos e Questionários , Resultado do Tratamento , Testes de Função Vestibular , Vestíbulo do Labirinto/fisiopatologia , Adulto Jovem
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