Semont maneuver vs. particle repositioning maneuver: comparative study | [Manovra di Semont vs. Particle Repositioning Maneuver: studio comparativo.]

In the present study 80 consecutive cases of PPV of the posterior semicircular canal are presented, with the purpose to evaluate the effectiveness of the treatment and to analyze the secondary Ny and re-test as indicators of the effectiveness of the therapeutic maneuver. The patients were treated in 40 cases with Particle Repositioning Maneuver (PRM) and in the other 40 with the Semont Maneuver, in an attempt to determine the secondary Nystagmus induced during treatment and any residual Paroxysmal Positional Nystagmus (PPNy) upon repetition of the Hallpike positioning after 15 minutes (re-test). Recovery was achieved in 80% of cases after the first session and in 95% of cases with the third session. PRM seemed to be slightly more effective. Secondary liberating Ny was frequently evoked (80%) and was reliable (75%) with the Semont Maneuver, while PRM yielded the liberating Ny in only 25% of cases, with lower reliability (70%). Reliability of the re-test with the Hallpike maneuver was high (80%) and the difference between the two techniques was negligible (78% in PRM and 85% in Semont). In conclusion, in terms of indicators of effectiveness, the Semont liberating Maneuver appears better in that it combines high therapeutic effectiveness (75% recovery in a single session) with a like percentage of liberating Ny (80%): this makes it possible to reserve the re-test and repetition of the therapeutic maneuver, performed during the same session, only in those cases that do not present liberating Ny (20% of cases). On the other hand, when the PRM is used, it appears better to rely on the high likelihood of effectiveness (85% in a single session) and then review the case directly at the next check-up rather than perform the Hallpike re-test in all cases that did not present the liberating secondary Ny (75%). In this way it is possible to select a small number of patients (22%) that still show PPNy (positive re-test) and for whom the therapeutic maneuver must be repeated.