The Relative Effectiveness of Semont’s and Epley’s Canalith Repositioning Maneuvers for Treatment of Posterior Canal BPPV: A Systematic Review

Abstract

Benign paroxysmal positional vertigo (BPPV) is considered as one of the most common disorder of peripheral vestibular system. Among different varieties of BPPV, posterior canal BPPV (PC-BPPV) is the most common type. Several maneuvers exist concurrently for the treatment of posterior canal with the Semont’s and the Epley’s maneuvers leading the popularity charts. Several Randomized control trials (RCT) have reported about the relative effectiveness of Semont’s and Epley’s maneuvers in alleviating the symptoms associated with the PC-BPPV. There are only few systematic reviews which have collated the outcomes of these RCTs to give a clear picture of one maneuver being superior to the other. So, the present study aimed at reviewing the recent studies comparing the effectiveness of Epley’s and Semont’s maneuver. Database search was done in Google scholar, PubMed, and Science direct. We selected only RCT studying adults with diagnosis of BPPV confirmed by the Dix-Hallpike test. The studies should have included both Epley’s and Semont’s. The main outcome was negative Dix-Hallpike test and the changes to subjective complaints. Articles found through the database search were entered into RAYYAN software. Duplicate removal, title screening, abstract screening and at the final stage full text screening was carried out. We could find 9 studies which followed the inclusion and exclusion criteria. Data was extracted from the selected studies. Selected RCT showed that the Epley’s and Semont’s maneuver are having good results on individuals with PC-BPPV. Most of the studies did not report of any complication after administering the maneuver. Comparing the relative effectiveness of a particular maneuver, Epley’s maneuver was found as safe and effective individuals with PC BPPV.