Appiani法与Zuma法治疗背地性水平半规管良性阵发性位置性眩晕的疗效比较
Comparison of the Efficacy of Appiani and Zuma Maneuvers in Patients with Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo.
文献信息
| PMID | 42867354 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Asuman Feda Bayrak |
| 作者单位 | Department of Otorhinolaryngology, Dokuz Eylül University, İzmir, Türkiye. |
| 期刊 | The journal of international advanced otology |
| SCI 分区 | Q3 |
| IF | 1.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 背地性水平半规管良性阵发性位置性眩晕（HC-BPPV）是BPPV中一种具有挑战性的变异型，与向地性形式相比治疗成功率较低。Appiani法（ApM）和Zuma法（ZmM）是两种针对该病症的复位策略，但头对头比较数据仍然有限。
方法： 于2024年12月至2025年11月期间进行了一项前瞻性随机比较研究。经视频眼震图（VNG）辅助的仰卧滚转试验确诊为单侧背地性HC-BPPV的患者被分配至ApM组（n = 38）或ZmM组（n = 39）。主要结局是位置性眼震的消失；次要结局是所需的手法治疗次数（最多4次）。随访期间发生半规管转换至其他半规管的患者被排除在疗效分析之外。
结果： 在77例患者中（63.6%为女性；59.7%年龄≥60岁），总体单次治疗消失率为63.6%。1次治疗后消失率在ApM组为68.4%，ZmM组为59.0%，组间差异无统计学意义（P = .389）。年龄较大（≥60岁）是唯一与需要≥2次治疗显著相关的因素（82.1% vs. 46.9%；P = .002）。
结论： ApM和ZmM均为治疗背地性HC-BPPV的有效且可比的方法。高龄（≥60岁）被确定为需要多次治疗的探索性相关因素。
英文摘要
BACKGROUND: Apogeotropic horizontal canal benign paroxysmal positional vertigo (HC-BPPV) is a challenging variant of BPPV with lower treatment success rates compared to the geotropic form. The Appiani maneuver (ApM) and the Zuma maneuver (ZmM) represent 2 repositioning strategies targeting this condition, but head-to-head comparative data remain limited.
METHODS: A prospective randomized comparative study was conducted between December 2024 and November 2025. Patients with unilateral apogeotropic HC-BPPV confirmed by videonystagmography (VNG)-assisted supine roll testing were assigned to either the ApM (n = 38) or the ZmM (n = 39). The primary outcome was resolution of positional nystagmus; the secondary outcome was the number of maneuver sessions required (maximum 4). Patients who developed canal conversion to another semicircular canal during follow-up were excluded from efficacy analysis.
RESULTS: Among 77 patients (63.6% female; 59.7% aged ≥ 60 years), the overall single-session resolution rate was 63.6%. Resolution after 1 session was achieved in 68.4% (ApM) and 59.0% (ZmM) of patients, with no significant between-group difference (P = .389). Older age (≥60 years) was the only factor significantly associated with requiring ≥2 sessions (82.1% vs. 46.9%; P = .002).
CONCLUSION: Both the ApM and ZmM are effective and comparable treatments for apogeotropic HC-BPPV. Advanced age (≥60 years) was identified as an exploratory factor associated with requiring multiple treatment sessions.