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A Chair-based Abbreviated Repositioning Maneuver (ChARM) for fast treatment of posterior BPPV

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To assess the effectiveness of a variation of the Epley maneuver, which we have titled “Chair-based Abbreviated Repositioning maneuver (ChARM)”, in solving cases of benign positional paroxysmal vertigo (BPPV) of the posterior canal. ChARM addresses multiple issues of highly overloaded medical centers that delay its due and timely resolution. For example it does not necessitate an examination bed/table and requires only a backed chair, and less than 3 min to be performed. In combination with a recently published abbreviated diagnostic maneuver it can solve BPPV cases within few minutes of single medical visit.

Methods

Patients being diagnosed with posterior BPPV by means of an abbreviated diagnostic maneuver were recruited. Immediately after diagnosis, a single attempt of ChARM was conducted. The patient was followed for 48 h and at 1 month after these procedures to assess the persistence of symptomatology.

Results

124 patients were treated with ChARM immediately after diagnosis during their very first medical visit. 92 patients (74.2%) solved their symptomatology completely after a single attempt of ChARM. The absence of symptoms persisted during the 30 days of follow-up.

Discussion

ChARM showed high success rates in solving posterior BPPV. The entire diagnostic-treatment procedure takes less than 5 min to perform and may allow direct treatment of patients, thereby avoiding unnecessary referrals or full vestibular testing. These abbreviated tools may be particularly useful in primary care settings or heavily overloaded otolaryngology or neurology departments.

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Funding

We received no financial resources during this study. Due to its methodology, no funding was necessary. Santiago de Chile, January 29th, 2019.

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Authors and Affiliations

  1. Otolaryngology Department, San Juan de Dios Hospital, University of Chile, Huérfanos, 3255, Santiago, Chile

    Pia Michael, Daniel Muñoz, Matías Gárate, Cristian Barraza, Marcia Nuñez & Hayo Andrés Breinbauer

  2. Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile

    Anton Tuma & Hayo Andrés Breinbauer

  3. Neuroscience Department, University of Chile, Santiago, Chile

    Hayo Andrés Breinbauer

Authors
  1. Pia Michael
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  2. Daniel Muñoz
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  3. Anton Tuma
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  4. Matías Gárate
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  5. Cristian Barraza
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  6. Marcia Nuñez
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  7. Hayo Andrés Breinbauer
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Correspondence to Hayo Andrés Breinbauer.

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Michael, P., Muñoz, D., Tuma, A. et al. A Chair-based Abbreviated Repositioning Maneuver (ChARM) for fast treatment of posterior BPPV. Eur Arch Otorhinolaryngol 276, 2191–2198 (2019). https://doi.org/10.1007/s00405-019-05460-2

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  • DOI: https://doi.org/10.1007/s00405-019-05460-2

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