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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.
KAYNAKLAR
  1. Bhattacharyya N, Baugh RF, Orvidas L, Barrs D, Bronston LJ, Cass S, et al; American Academy of Otolaryngology-Head and Neck Surgery Foundation. Clinical practice guideline: benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 2008;139(5 Suppl 4):S47-81. [Crossref]  [PubMed] 
  2. Baloh RW, Jacobson K, Honrubia V. Horizontal semicircular canal variant of benign positional vertigo. Neurology. 1993;43(12):2542-9. [Crossref]  [PubMed] 
  3. Cakir BO, Ercan I, Cakir ZA, Civelek S, Sayin I, Turgut S. What is the true incidence of horizontal semicircular canal benign paroxysmal positional vertigo? Otolaryngol Head Neck Surg. 2006;134(3):451-4. [Crossref]  [PubMed] 
  4. Chung KW, Park KN, Ko MH, Jeon HK, Choi JY, Cho YS, et al. Incidence of horizontal canal benign paroxysmal positional vertigo as a function of the duration of symptoms. Otol Neurotol. 2009;30(2):202-5. [Crossref]  [PubMed] 
  5. McClure JA. Horizontal canal BPV. J Otolaryngol. 1985;14(1):30-5. [PubMed] 
  6. Libonati GA, Martellucci S, Castellucci A, Malara P. Minimum stimulus strategy: a step-by-step diagnostic approach to BPPV. J Neurol Sci. 2022;434:120158. [Crossref]  [PubMed] 
  7. Epley JM. Positional vertigo related to semicircular canalithiasis. Otolaryngol Head Neck Surg. 1995;112(1):154-61. [Crossref]  [PubMed] 
  8. Kim CH, Kim MB, Ban JH. Persistent geotropic direction-changing positional nystagmus with a null plane: the light cupula. Laryngoscope. 2014;124(1):E15-9. [Crossref]  [PubMed] 
  9. Choung YH, Shin YR, Kahng H, Park K, Choi SJ. 'Bow and lean test' to determine the affected ear of horizontal canal benign paroxysmal positional vertigo. Laryngoscope. 2006;116(10):1776-81. [Crossref]  [PubMed] 
  10. Marcelli V. Nystagmus intensity and direction in bow and lean test: an aid to diagnosis of lateral semicircular canal benign paroxysmal positional vertigo. Acta Otorhinolaryngol Ital. 2016;36(6):520-6. [Crossref]  [PubMed]  [PMC] 
  11. Nuti D, Agus G, Barbieri MT, Passali D. The management of horizontal-canal paroxysmal positional vertigo. Acta Otolaryngol. 1998;118(4):455-60. [Crossref]  [PubMed] 
  12. Casani AP, Vannucci G, Fattori B, Berrettini S. The treatment of horizontal canal positional vertigo: our experience in 66 cases. Laryngoscope. 2002;112(1):172-8. [Crossref]  [PubMed] 
  13. Lempert T, Tiel-Wilck K. A positional maneuver for treatment of horizontal-canal benign positional vertigo. Laryngoscope. 1996;106(4):476-8. [Crossref]  [PubMed] 
  14. Lopez-Escamez JA, Gamiz MJ, Fernandez-Perez A, Gomez-Fi-ana M, Sanchez-Canet I. Impact of treatment on health-related quality of life in patients with posterior canal benign paroxysmal positional vertigo. Otol Neurotol. 2003;24(4):637-41. [Crossref]  [PubMed] 
  15. Li JC, Li CJ, Epley J, Weinberg L. Cost-effective management of benign positional vertigo using canalith repositioning. Otolaryngol Head Neck Surg. 2000;122(3):334-9. [Crossref]  [PubMed] 
  16. Karapolat H, Eyigor S, Kirazli Y, Celebisoy N, Bilgen C, Kirazli T. Reliability, validity, and sensitivity to change of Turkish Activities-specific Balance Confidence Scale in patients with unilateral peripheral vestibular disease. Int J Rehabil Res. 2010;33(1):12-8. [Crossref]  [PubMed] 
  17. von Brevern M, Bertholon P, Brandt T, Fife T, Imai T, Nuti D, et al. Benign paroxysmal positional vertigo: Diagnostic criteria. J Vestib Res. 2015;25(3-4):105-17. [Crossref]  [PubMed] 
  18. Fife TD. Recognition and management of horizontal canal benign positional vertigo. Am J Otol. 1998;19(3):345-51. [PubMed] 
  19. Han BI, Oh HJ, Kim JS. Nystagmus while recumbent in horizontal canal benign paroxysmal positional vertigo. Neurology. 2006;66(5):706-10. [Crossref]  [PubMed] 
  20. Koo JW, Moon IJ, Shim WS, Moon SY, Kim JS. Value of lying-down nystagmus in the lateralization of horizontal semicircular canal benign paroxysmal positional vertigo. Otol Neurotol. 2006;27(3):367-71. [Crossref]  [PubMed] 
  21. Lee SH, Choi KD, Jeong SH, Oh YM, Koo JW, Kim JS. Nystagmus during neck flexion in the pitch plane in benign paroxysmal positional vertigo involving the horizontal canal. J Neurol Sci. 2007;256(1-2):75-80. [Crossref]  [PubMed] 
  22. Bisdorff AR, Debatisse D. A new differential diagnosis for spontaneous nystagmus: lateral canal cupulolithiasis. Ann N Y Acad Sci. 2002;956:579-80. [Crossref]  [PubMed] 
  23. Koju G, Bing D, Zhou LQ, Mao ZY, Tao YL, Chen QG, et al. Comparisons of Supine Roll Test and Alternative Positional Tests in HC-BPPV Lateralization. Curr Med Sci. 2022;42(3):613-9. [Crossref]  [PubMed] 
  24. Roberts RA, Abrams H, Sembach MK, Lister JJ, Gans RE, Chisolm TH. Utility measures of health-related quality of life in patients treated for benign paroxysmal positional vertigo. Ear Hear. 2009;30(3):369-76. [Crossref]  [PubMed] 
  25. Kim K-S J, Joo YH, Park SY, Han GC. The dizziness handicap inventory and its relationship with vestibular diseases. J Int Adv Otol. 2012;8(1):69-77. [Link] 
  26. D'Silva LJ, Whitney SL, Santos M, Dai H, Kluding PM. The impact of diabetes on mobility, balance, and recovery after repositioning maneuvers in individuals with benign paroxysmal positional vertigo. J Diabetes Complications. 2017;31(6):976-82. [Crossref]  [PubMed]  [PMC] 
  27. Martens C, Goplen FK, Aasen T, Nordfalk KF, Nordahl SHG. Dizziness handicap and clinical characteristics of posterior and lateral canal BPPV. Eur Arch Otorhinolaryngol. 2019;276(8):2181-9. [Crossref]  [PubMed]