俯卧位眼震在原发性水平半规管BPPV复位过程中的临床意义OA

Objective To investigate the clinical significance of nystagmus in the prone position during repositioning maneuver in patients with primary horizontal semicircular canal benign paroxysmal positional vertigo(BPPV).Methods A total of 86 patients diagnosed with horizontal semicircular canal BPPV via the roll test at the Vertigo Clinic,Department of Otorhinolaryngology Head and Neck Surgery,Peking University People's Hospital(Qingdao)from January 2023 to February 2025 were enrolled,including 40 males and 46 females aged 16~80 years.The modified Barbecue maneuver was adopted for repositioning in patients with horizontal canal cupulolithiasis(HC-Cup)after otoliths were released,and in patients with horizontal canal canalithiasis(HC-Can),while observing nystagmus in the prone position during repositioning.Based on the manifestation of prone-position nystagmus during the initial repositioning,patients were divided into Group A(with transient[less than 3 episodes]or no horizontal nystagmus and Group B(showing persistent horizontal nystagmus[≥3 to 5 consecutive episodes]),and responses to the initial repositioning were compared between the two groups.Results Of the patients in Group A(n=60),initial repositioning yielded complete recovery in 52,partial response in 4,and no benefits in 4,while treatment in Group B(n=26)produced complete recovery in only 1 patient,partial response in 11,and no response in 14.The rank-sum mean rank of initial repositioning efficacy was 54.37 in Group A and 18.42 in Group B(P<0.05),with no significant intergroup differences in disease course,age and gender(all P>0.05).Conclusions Prone-position nystagmus during repositioning for horizontal semicircular canal BPPV can serve as an immediate indicator for predicting repositioning success.Combined with standardized examinations and quality control of repositioning procedures,this sign can guide the selection of subsequent treatment protocols and significantly improve the rate of repositioning success.