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The authors performed a systematic review assessing the utilisation of multi-axial repositioning chairs, such as the TRV chair and the Epley Omniax Rotator, in the diagnosis and treatment of BPPV. They reviewed nine studies, of which four were prospective studies. There were no randomised controlled trials. In all studies, the diagnosis of BPPV in patients was made using video nystagmography (VNG) goggles. Interestingly, perhaps due to the use of VNG, the studies found a higher incidence of non-posterior canal BPPV and multi-canal BPPV than previously described in the literature. There was one prospective study that compared the use of the chair and manual repositioning. The study found no statistically significant difference between the two methods in treatment outcomes at four, 12 and 24 weeks, although they found that patients using the chair required fewer sessions for successful repositioning. In general, the repositioning chairs were found to be highly effective in treating patients with BPPV with a recurrence rate varying between 11% and 28%. Patients with non-posterior canal BPPV, multi-canal involvement and cupulolithiasis were found to be more difficult to manage, even when using the repositioning chair. The repositioning chairs were generally well tolerated, although some claustrophobic patients might find it challenging. In summary, the multi-axial repositioning chair appears most useful to assist in the diagnosis of difficult BPPV cases, the treatment of patients who may struggle with manual canal reposition treatment (spinal problems) and refractory cases.

Repositioning chairs in the diagnosis and treatment of benign paroxysmal positional vertigo – a systematic review.
S Abdulovski, M Klokker.
J INT ADV OTOL
2021;17(4):353-60.
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CONTRIBUTOR
Sam Cho

Queens Medical Centre, Nottingham, UK.

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