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ORIGINAL RESEARCH

Using of the Bow and Lean Test in Patients with Lateral Canal Benign Paroxysmal Positional Vertigo
Lateral Kanal Benign Paroksismal Pozisyonel Vertigosu Olan Hastalarda Bow ve Lean Testinin Kullanımı
Received Date : 17 Feb 2023
Accepted Date : 11 Mar 2023
Available Online : 20 Mar 2023
Doi: 10.24179/kbbbbc.2023-96184 - Makale Dili: TR
KBB ve BBC Dergisi. 2023;31(2):115-20
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: It was aimed to evaluate the effectiveness of Bow and Lean test to determine the correct channel and its cause in patients with lateral semicircular canal (LCC) benign paroxysmal positional vertigo (BPPV) to determine how much it supports the routinely used head-roll test. Material and Methods: Between May 2022 and January 2023, 41 (28 female, 13 male) patients with dizziness and diagnosed with lateral canal BPPV were included in the study. All patients were recorded with videonystagmography following the Otorhinolaryngology examination. Static positional test (turning head) and dynamic positional test (Dix-Hallpike), Bow and Lean test were performed. The Dizziness Disability Inventory was administered to the patients before and after the canalith reposition maneuver. Obtained data were analyzed statistically. Results: The mean age of the patients was 56.0515.4 (between 18 and 80). LCC channelolithiasis was diagnosed in 25 patients and LCC cupulolithiasis was diagnosed in 16 patients in positional tests. Diagnostic confirmation with Bow and Lean tests was found in 60% of canalolithiasis cases and 87.5% in cupulolithiasis cases. The difference between the two diagnoses was not statistically significant (p=0.059). There was a statistically significant decrease in the Dizziness Disability Inventory scores after treatment in patients diagnosed with both canalolithiasis and cupulolithiasis (p<0.005). However, there was no statistical difference between the scores in both diagnostic groups and the support status of Bow and Lean tests (p>0.005). Conclusion: According to the findings obtained in this study, Bow and Lean tests are highly positive in LCC cupulolithiasis. However, this test has not been shown to have an effect on treatmentrelated quality of life in patients.
ÖZET
Amaç: Lateral semisirküler kanal (LSK), benign paroksismal pozisyonel vertigosu (BPPV) olan hastalarda doğru kanalı ve nedenini belirlemek için Bow ve Lean testinin etkinliğinin değerlendirilmesi ve rutinde kullanılan baş çevirme testini ne kadar desteklediğinin saptanması amaçlandı. Gereç ve Yöntemler: Çalışmaya Mayıs 2022-Ocak 2023 tarihleri arasında baş dönmesi şikâyeti olan ve lateral kanal BPPV tanısı konan 41 (28 kadın, 13 erkek) hasta dâhil edildi. Tüm hastalara kulak burun boğaz muayenesini takiben videonistagmografi ile kayıt yapıldı. Statik pozisyonel test (baş çevirme) ve dinamik pozisyonel test (Dix-Hallpike), Bow ve Lean testi yapıldı. Hastalara kanalit repozisyon manevrası öncesi ve sonrası Baş Dönmesi Engellilik Envanteri uygulandı. Elde edilen veriler istatistiksel olarak analiz edildi. Bulgular: Hastaların yaş ortalaması 56,0515,4 (18-80 arası) idi. Pozisyonel testlerde 25 hastada LSK kanalolitiazis, 16 hastada LSK kupulolitiazis tanısı konuldu. Bow ve Lean testleri ile tanı doğrulaması kanalolitiazis olgularında %60, kupulolitiazis olgularında %87,5 olarak bulundu. İki tanı arasındaki fark istatistiksel olarak anlamlı değildi (p=0,059). Baş Dönmesi Engellilik Envanteri skorlarında hem kanalolitiazis hem de kupulolitiazis tanısı konan olgularda tedavi sonrası istatistiksel olarak anlamlı düşüş sağlandı (p<0,005). Ancak her iki tanı grubunda ve Bow ve Lean testinin destekleme durumuna göre skorlar arasında istatistiksel farklılık saptanmadı (p>0,005). Sonuç: Bu çalışmada elde edilen bulgulara göre Bow ve Lean testi LSK kupulolitiaziste yüksek oranda pozitif olmaktadır. Ancak bu testin hastalarda tedaviye bağlı yaşam kalitesi üzerine bir etkisi gösterilememiştir.
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