Epley and Semont Maneuvers for Posterior Canal Benign Paroxysmal Positional Vertigo: A Network Meta-Analysis

Laryngoscope

Liu, Y., Wang, W., et al. (2016).

Laryngoscope, 126(4), 951-955.

This meta-analysis investigates the efficacy of the Semont and Epley maneuvers to improve symptoms of posterior canal benign paroxysmal positional vertigo in adults.

No funding received

Through April 2015

Randomized controlled trials

12

Overall, both Epley and Semont maneuvers demonstrated stronger results and more rapid recovery rates for adults with posterior canal benign paroxysmal positional vertigo (PC-BPPV) symptoms as compared to sham treatments. However, "the Epley maneuver may be superior in the long run to the Semont maneuver" (p. 954).<ul> <li>At one week, six studies found no significant difference between the Epley and Semont maneuvers (odds ratio = 1.8, 95% CI = 0.48-7.0), but significant superiority as compared to sham-controlled subjects (OR = 16, 95% CI = 3.8-70; OR = 9, 95% CI = 1.7-45).</li> <li>At the end of the study period, eleven studies reported no significant difference between the Epley and Semont maneuvers (OR = 1.8, 95% CI = 0.47-7.2), but significantly superior recovery rates as compared to sham-controlled subjects (OR = 16, 95% CI = 3.8-72 and OR = 8.8, 95% CI = 1.7-45, respectively).</li> <li>Six studies documenting the relapse of PC-BPPV symptoms reported no significant difference between Epley and Semont maneuvers. "Compared with the sham-controlled subjects, the Epley and Semont maneuvers showed less recurrence; however, the differences were not significant (OR = 0.13, 95% CI = 0.01-2.2 and OR = 0.13, 95% CI = 0.01-1.3, respectively)" (p. 953).</li></ul>