Outcome of Gans Repositioning Maneuver in Patients with Posterior Canal Benign Paroxysmal Positional Vertigo with Cervical Spondylosis

Published on: May 5, 2020

Indian Journal of Otology ¦ Volume 25 ¦ Issue 4 ¦ October-December 2019

H. Gayathri, Gurushekar Rose Preethi, Paul Mary P. Christina
Departments of ENT and Community Medicine, ACS Medical College and Hospital, Chennai, Tamil Nadu, India

Abstract
Background and Objectives: Cervical spondylosis and BPPV often co-exist in older population. As GRM doesn’t involve hyperextension of neck, which is better avoided among patients with cervical spine pathology, we decided to assess the outcome of GRM in patients with cervical spondylosis in terms of safety & efficacy. Methodology: Twenty patients with clinically proven posterior semicircular canal BPPV and radiologically evident cervical spondylosis without symptomatic spondylotic myelopathy or radiculopathy or severe restriction of neck or back movement were enrolled. GRM was done on the first day and repeated until resolution of nystagmus, for a maximum of four times. Lack of response to GRM even after fourth attempt was considered as failure. The manuever was repeated in the successful group on day two and after one week & these patients were followed up for one month. Results: Overall, 75% of the patients (50.9% to 91.3% – 95% C.I.) had a successful repositioning maneuver. Favourable parameters for better chances of cure were higher age (>55 years), male gender & higher grade of cervical spondylosis. 20% of patients had experienced temporary pain for few hours on the day of maneuver. None of the patients who had less than two attempts of GRM had post-procedure pain. Clinically, none of the patients had precipitation of cervical myelopathy or radiculopathy. Conclusion: GRM is a safe & effective particle repositioning maneuver for patients with posterior semicircular canal BPPV
with co-existent cervical spondylosis.

 

Read Article

Recent Posts

Part 3 – Audiovestibular Migraine What Audiologists and ENTs Need to Know in 2022 for Expanding Patient Care

Published on: December 13, 2022

Tech Topic | December 2022 Hearing Review Millions of patients needlessly go without proper diagnosis and treatment each year. It is the authors’ hope that readers will become more interested […]

Read more

Part 2 – Audiovestibular Symptoms Related to Migraine – What Audiologists and ENTs Need to Know in 2022 for Expanding Patient Care

Published on: November 7, 2022

Tech Topic | November 2022 Hearing Review One of the greatest challenges in the evaluation and management of patients with migraine is the diversity in the presentation of symptoms among […]

Read more

Part 1 – Audiovestibular Symptoms Related to Migraine – What Audiologists and ENTs Need to Know In 2022 For Expanding Patient Care

Published on: October 14, 2022

Patient Care | October 2022 Hearing Review Migraine affects nearly 40 million individuals in the United States, more than asthma and diabetes combined. Most will have dizziness, vertigo, misophonia, and […]

Read more

Gans repositioning maneuver for the posterior canal BPPV patients: systematic review and meta‑analysis

Published on: April 25, 2022

European Archives of Oto-Rhino-Laryngology Published: April 6, 2022 Authors Deepika Joshi1 · Vyom Gyanpuri2 · Abhishek Pathak1 · Rameshwar Nath Chaurasia1 · Vijay Nath Mishra1 · Anand Kumar1 · Varun […]

Read more