Auris, nasus, larynx · 2026
Therapeutic strategies for benign paroxysmal positional vertigo of the Japan Society for Equilibrium Research.
СтатьяКлинические рекомендацииСистематический обзорНазвание и аннотация: Перевод в очереди
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Imai Takao, Hashimoto Makoto, Watanabe Yukio, Shigeno Kohichiro, Nakamura Tadashi, Takahashi Koji, Asai Masatsugu, Yamamoto Masahiko, Takei Yasuhiko, Ikeda Takuo, Sato Go, Takeda Noriaki, Shojaku Hideo
Аннотация
OBJECTIVE: The Japan Society for Equilibrium Research (JSER) published the Japanese Clinical Practice Guideline for Benign Paroxysmal Positional Vertigo (BPPV) 2023 to propose therapeutic strategies for BPPV. This review focuses on clinical questions (CQs) and treatment recommendations of the guideline.
METHODS: The Committee for Clinical Practice Guidelines of JSER formulated CQs related to the treatment of BPPV in accordance with the Minds Manual for Guideline Development 2020 and conducted a structured literature search. A systematic review was carried out to evaluate the quality of evidence, and the recommendation statements, recommendation levels, evidence levels, and references were decided.
RESULTS: The Committee for Clinical Practice Guidelines of JSER formulated 10 CQs concerning the efficacy of the canalith repositioning procedure (CRP) with adjunctive maneuvers, medical and surgical treatments, natural history and risk factors of BPPV, and proposed recommendation statements to answer the CQs with levels of evidence and recommendation.
CONCLUSION: The CRP is strongly recommended for the treatment of BPPV. Mastoid vibration during the CRP and postural restriction after the CRP have no additional effects. Because BPPV is self-limited, observation without the CRP is acceptable for 1 week after the onset. Risk factors for the development of BPPV include female sex, a low serum vitamin D level, osteoporosis, migraine, head trauma, and a high total cholesterol level. Supplementation of vitamin D and/or calcium reduces the recurrence rate of BPPV in patients with low serum vitamin D levels. Canal-plugging surgery is effective for the treatment of intractable BPPV. Drug treatment after the CRP may improve dizziness handicap inventory scores in patients with BPPV.
METHODS: The Committee for Clinical Practice Guidelines of JSER formulated CQs related to the treatment of BPPV in accordance with the Minds Manual for Guideline Development 2020 and conducted a structured literature search. A systematic review was carried out to evaluate the quality of evidence, and the recommendation statements, recommendation levels, evidence levels, and references were decided.
RESULTS: The Committee for Clinical Practice Guidelines of JSER formulated 10 CQs concerning the efficacy of the canalith repositioning procedure (CRP) with adjunctive maneuvers, medical and surgical treatments, natural history and risk factors of BPPV, and proposed recommendation statements to answer the CQs with levels of evidence and recommendation.
CONCLUSION: The CRP is strongly recommended for the treatment of BPPV. Mastoid vibration during the CRP and postural restriction after the CRP have no additional effects. Because BPPV is self-limited, observation without the CRP is acceptable for 1 week after the onset. Risk factors for the development of BPPV include female sex, a low serum vitamin D level, osteoporosis, migraine, head trauma, and a high total cholesterol level. Supplementation of vitamin D and/or calcium reduces the recurrence rate of BPPV in patients with low serum vitamin D levels. Canal-plugging surgery is effective for the treatment of intractable BPPV. Drug treatment after the CRP may improve dizziness handicap inventory scores in patients with BPPV.