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
Özge KALEa, Cevahir Bulut TURAYa, Hatice Seyra ERBEKa
aBaşkent Üniversitesi Tıp Fakültesi, Kulak Burun Boğaz Hastalıkları ABD, Ankara, Türkiye
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 56.0515.4 (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.
Keywords: Dizziness; benign paroxysmal positional vertigo; vertigo
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 56,0515,4 (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.
Anahtar Kelimeler: Baş dönmesi; benign paroksismal pozisyonel vertigo; vertigo
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