This document summarizes benign paroxysmal positional vertigo (BPPV), a common cause of positional vertigo. It describes the pathophysiology of BPPV, involving debris accumulating in the posterior or horizontal semicircular canals, causing vertigo when the head is moved into certain positions. It outlines diagnostic tests like the Dix-Hallpike maneuver and treatments including the Epley maneuver and particle repositioning maneuvers, which aim to move the debris out of the affected canal.
1) A feasibility study was conducted to assess the potential effectiveness of music training for patients with tinnitus. 92 subjects with tinnitus were recruited and instructed to listen to digitally modified music.
2) Patients' tinnitus was matched and their severity was assessed using the Tinnitus Handicap Inventory (THI) questionnaire before and after the study. 35 subjects completed the 3 month music therapy training.
3) Preliminary results found the average THI score improved after therapy, indicating reduced tinnitus severity. Subjects with different tinnitus characteristics saw varying levels of improvement. Further studies are still needed to evaluate outcomes.
1) This case report describes a 65-year-old female patient who presented with sudden deafness in the right ear as well as persistent direction-changing positional nystagmus.
2) Initial tests found benign paroxysmal positional vertigo (BPPV) involving the right horizontal semicircular canal, but forced prolonged positioning maneuvers failed to resolve her symptoms.
3) The persisting geotrophic nystagmus is proposed to be caused by a phenomenon called a "light cupula" rather than free-floating particles in the canal.
1) A feasibility study was conducted to assess the potential effectiveness of music training for patients with tinnitus. 92 subjects with tinnitus were recruited and instructed to listen to digitally modified music.
2) Patients' tinnitus was matched and their severity was assessed using the Tinnitus Handicap Inventory (THI) questionnaire before and after the study. 35 subjects completed the 3 month music therapy training.
3) Preliminary results found the average THI score improved after therapy, indicating reduced tinnitus severity. Subjects with different tinnitus characteristics saw varying levels of improvement. Further studies are still needed to evaluate outcomes.
1) This case report describes a 65-year-old female patient who presented with sudden deafness in the right ear as well as persistent direction-changing positional nystagmus.
2) Initial tests found benign paroxysmal positional vertigo (BPPV) involving the right horizontal semicircular canal, but forced prolonged positioning maneuvers failed to resolve her symptoms.
3) The persisting geotrophic nystagmus is proposed to be caused by a phenomenon called a "light cupula" rather than free-floating particles in the canal.
Functional endoscopic sinus surgery complicated with orbital hemorrhageDavid Yeh
This document describes a case of orbital hemorrhage that occurred during functional endoscopic sinus surgery (FESS). Key details:
- A patient underwent uneventful FESS surgery but later developed swelling and ecchymosis of the right eye.
- An orbital hematoma was discovered, which can occur due to injury of orbital veins during surgery. The patient recovered fully after 2 weeks.
- The document then discusses risks of orbital and surrounding structures during FESS, including the lamina papyracea, optic nerve, and arteries. Preventing and managing complications of FESS is important.
The document discusses the career experiences of Dr. Ye Dawei, an ear, nose, and throat specialist at Zhiliu Hospital in Hsinchu. It shares his memories from attending Hsinchu Middle School, experiences studying medicine, and insights from his medical career. It also questions what personality traits are suitable for studying medicine and includes the Hippocratic Oath pledging to serve patients with purity, holiness and prioritizing their health above all else.
A Single Therapy for All Subtypes of Horizontal Canal Positional VertigoDavid Yeh
This document describes a study that evaluated a single therapy approach for treating all subtypes of horizontal canal benign paroxysmal positional vertigo (HC-BPPV). The study included 89 patients diagnosed with HC-BPPV who were treated with forced prolonged position (FPP), lying on the side of weaker nystagmus for 12 hours. All subtypes, including canalolithiasis (Can), cupulolithiasis with otoliths on the utricle side (Cup-U), and cupulolithiasis with otoliths on the canal side (Cup-C), were effectively treated with FPP in less than four sessions. The results support using FPP as a
1) The document discusses the management of horizontal canal benign paroxysmal positional vertigo (HC-BPPV) using rapid head rotation.
2) 132 BPPV patients were diagnosed and treated, with 41 cases of HC-BPPV. Most HC-BPPV cases were treated with barbecue maneuver and/or forced prolonged position with good results.
3) Intractable HC-BPPV cases were treated with rapid head rotation, which was effective in resolving vertigo in most cases, especially for HC-Cupulolithiasis.
1) The document reports on a study of 132 patients with horizontal canal benign paroxysmal positional vertigo (HC-BPPV) treated with barbecue maneuver, forced prolonged position (FPP), and/or rapid head rotation.
2) Results found that barbecue maneuver and/or FPP resolved HC-BPPV in 22 patients, while rapid head rotation resolved HC-BPPV in 7 patients, inducing different nystagmus responses.
3) The document concludes that FPP and barbecue maneuver remain first choice treatments for HC-BPPV, while rapid head rotation can be used for intractable cases, especially cupulolithiasis cases. Nystagmus direction depends on
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
Functional endoscopic sinus surgery complicated with orbital hemorrhageDavid Yeh
This document describes a case of orbital hemorrhage that occurred during functional endoscopic sinus surgery (FESS). Key details:
- A patient underwent uneventful FESS surgery but later developed swelling and ecchymosis of the right eye.
- An orbital hematoma was discovered, which can occur due to injury of orbital veins during surgery. The patient recovered fully after 2 weeks.
- The document then discusses risks of orbital and surrounding structures during FESS, including the lamina papyracea, optic nerve, and arteries. Preventing and managing complications of FESS is important.
The document discusses the career experiences of Dr. Ye Dawei, an ear, nose, and throat specialist at Zhiliu Hospital in Hsinchu. It shares his memories from attending Hsinchu Middle School, experiences studying medicine, and insights from his medical career. It also questions what personality traits are suitable for studying medicine and includes the Hippocratic Oath pledging to serve patients with purity, holiness and prioritizing their health above all else.
A Single Therapy for All Subtypes of Horizontal Canal Positional VertigoDavid Yeh
This document describes a study that evaluated a single therapy approach for treating all subtypes of horizontal canal benign paroxysmal positional vertigo (HC-BPPV). The study included 89 patients diagnosed with HC-BPPV who were treated with forced prolonged position (FPP), lying on the side of weaker nystagmus for 12 hours. All subtypes, including canalolithiasis (Can), cupulolithiasis with otoliths on the utricle side (Cup-U), and cupulolithiasis with otoliths on the canal side (Cup-C), were effectively treated with FPP in less than four sessions. The results support using FPP as a
1) The document discusses the management of horizontal canal benign paroxysmal positional vertigo (HC-BPPV) using rapid head rotation.
2) 132 BPPV patients were diagnosed and treated, with 41 cases of HC-BPPV. Most HC-BPPV cases were treated with barbecue maneuver and/or forced prolonged position with good results.
3) Intractable HC-BPPV cases were treated with rapid head rotation, which was effective in resolving vertigo in most cases, especially for HC-Cupulolithiasis.
1) The document reports on a study of 132 patients with horizontal canal benign paroxysmal positional vertigo (HC-BPPV) treated with barbecue maneuver, forced prolonged position (FPP), and/or rapid head rotation.
2) Results found that barbecue maneuver and/or FPP resolved HC-BPPV in 22 patients, while rapid head rotation resolved HC-BPPV in 7 patients, inducing different nystagmus responses.
3) The document concludes that FPP and barbecue maneuver remain first choice treatments for HC-BPPV, while rapid head rotation can be used for intractable cases, especially cupulolithiasis cases. Nystagmus direction depends on
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
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1. Benign Paroxysmal Positional Vertigo
300 Formosan J Med 2023 Vol.27 No.3
ؼ
ؼ܄ତว܄Տ܄ཀྵ
ဨσ
ᄔ
ᄔाǺؼ܄ତว܄Տ܄ཀྵ(benign paroxysmal positional vertigo, BPPV)ࢂᓐཀྵനதـޑੰӢǶ
Dix-Hallpike maneuver ёບᘐऊ՞Ըҡੱ 8 ԋࡕޑъೕᆅԸҡੱ(posterior canal BPPV, PC-BPPV)ǴԸޑ
ԸҡӢख़ΚϐࡺǴϣరЃనࢬǴठ൙ဎ(ampulla)ޑഗ൰(cupula)ୃ౽Ǵᇨวрӛٳ㥲܄ਁǴ
Epley maneuver ک Sémont maneuver ԸҡൺՏೌࢂݯᕍ२ᒧǶѳ፴ΠѰѓୁ፴ᔠ(supine to head-lateral
test)ёບᘐऊ՞Ըҡੱ 2 ԋޑНѳъೕᆅԸҡੱ(horinzotal canal BPPV, HC-BPPV)ǴрӛӦਁࣁᆅԸ
ҡࠠНѳъೕᆅԸҡੱǴрӦਁࣁഗ൰؈ҡࠠНѳъೕᆅԸҡੱǶݯᕍБԄԖុ༈(ݤforced
prolonged position, FPP)Ǵջᡣੰ፴ӛਁၨ১ୁೱុ 10-12 λਔǴᜤаߏڙ܍ਔ໔ୁ፴ޣё௦ҔځѬ
ൺՏೌݯᕍǴӵ barbecue maneuver ک Gufoni maneuverǶъೕᆅԸҡੱ(anterior canal BPPV, AC-BPPV)
നࣁـشǴDix-Hallpike maneuver ևӛΠਁǴݯᕍБԄЙԵቾԸࣁՖୁǴ֡௦ᓐһᝌൺՏೌ(deep
head hanging maneuver)Ƕ
ᜢ
ᜢᗖຒǺ܄ؼତว܄Տ܄ཀྵǴਁǴъೕᆅǴᆅԸҡǴഗ൰؈ҡǴԸҡൺՏೌ
(ѠᙴᏢ Formosan J Med 2023;27:300-11) DOI:10.6320/FJM.202305_27(3).0007
ق
ق
列⿏昋䘤⿏ỵ伖⿏䛑㘰(benign paroxysmal
positional vertigo, BPPV)⍰䧙俛䞛䕯炻㗗䛑㘰攨姢
㚨ⷠ夳䘬䕦䕭ˤỵ㕤⇵⹕ℏ䘬㨊⚻♲(utricle)䘬俛
䞛⚈㓭㺪句军ᶱ⋲夷䭉ᷕㆾ湷旬㕤⋲夷䭉⢢儡䘬
枪ⷥ嗽炻㓭侴婀䘤䛑㘰ˤBPPV 䘬冐⸲堐䎦䁢䔞䕭
か柕悐廱≽⇘㝸ᶨỵ伖㗪炻↢䎦䞕㙓䘬昋䘤⿏䛑
㘰ˤ㬌䕯⤥䘤㕤 50-60 㬚䘬侩⸜Ṣᶼ⤛⿏庫⣂炻䓂
⮹䘤䓇㕤⬑䪍ˤ
ὅ䕭⚈⎗↮䁢䈡䘤⿏临䘤⿏炻⍇⚈ᶵ㖶䘬
䈡䘤⿏ BPPV Ỽ 50%ẍᶲ炻⸜䲨ˣ橐岒䔷檮ˣ䵕䓇
䳈 D 仢᷷䕯ˣ檀埨⡻ˣ檀埨傪ˣ檀⯧愠ˣῷ柕䖃
䫱悥⎗傥㚱䚠斄ˤ临䘤⿏ BPPV ⣂临䘤㕤⇵⹕䤆䴻
䀶ˣ㠭⯤䇦㮷䕯ˣ䨩䘤⿏倥≃晄䣁ˣ俛䥹ㇳ埻柕
悐⢾ 䫱ˤ晾婒䕭か⣂⎗冒埴䶑妋炻Ữ㚱ṃ䕭か䓂
军天㔠㚰⼴炻䓇㳣ㇵ傥《⽑㬋ⷠ炻喍䈑⮵㬌䕯䃉栗
叿䗪㓰炻㚱䞼䨞㊯↢⽆䘤ἄ⇘㱣䗪炻℞䕭䦳⎗忼
18 ᾳ㚰ᷳᷭ炻㓭 BPPV ᷎朆ℐ䃞㗗ᶨ冒旸⿏䕦䕭炻
⺢嬘ṵ暨䧵㤝㱣䗪[1]ˤ
BPPV 䕭か⣂ᷣ姜℞䛑㘰㚫⚈幢ᶳˣ⸲ᶲⶎ⎛
侣幓ˣᾗ幓ẘ柕㗪婀䘤炻䓇㳣ᷕ媠⤪崟⸲ˣ㰸㴜
㲿柕ˣἄ⚺喅ˣ䚳䈁慓ㆾἄ伶⭡㗪䘤䓇ˤ侴⛐昋䘤
⿏䛑㘰 㬊⼴䘬㔠⮷㗪⇘㔠⣑炻㚱ṃ䕭かṎ㚫㉙⿐
⸛堉嬲ⶖˣ㕳廱デˣ埴崘⚘暋ˣ柕㖷ˣ◩⽫ˣ▼⎸ˣ
㕄デˣ↢㯿ˣ㺪㴖デˣ夾≃㧉䱲ˣ夾䈑嶛≽䫱ˤ
昋䘤⿏ỵ伖⿏䛤㋗䓙媦居䇦䋶⼿ᷣ Barany[2]
㕤 1921 ⸜椾⃰㍸↢炻Ṿ㍷徘Ḯ 1 ỵ 27 㬚⤛⿏䕭か
⍵央䘤ἄ䛑㘰 2 忙炻ᶼ⎒䘤ἄ㕤⎹⎛“幢ᶳ㗪炻䕭
か↢䎦⻟䁰䛑㘰᷎⎗夳㕳廱ㆸấ⎹⎛ˣ✪䚜ㆸấ⎹
ᶲ䘬䛤㋗炻⎹⎛䚳㗪↢䎦╖䲼䘬㕳廱䛤㋗炻⎹ⶎ䚳
㗪↢䎦╖䲼䘬✪䚜⎹ᶲ䛤㋗ˤDix Hallpike[3]ℵ
㕤 1952 ⸜ἄ忚ᶨ㬍斉慳炻娵䁢枰䫎⎰ᶳ↿⸦枭㡅
ẞㇵ㗗 BPPV 䘬℠✳䛤㋗烉
ᶨ.ġ ⎗䓙柕ỵ嬲㎃㗪婀䘤烊
Ḵ.ġ か“俛㛅ᶳἄ Dix-Hallpike maneuver 柕ỵ嬲
⊾㩊㞍㗪炻䛤㋗⏰⺣㕳⎹⛘⿏烊
ᶱ.ġ ⛐柕ỵ嬲⊾⼴㚫㚱⸦䥺䘬⺞怚ㇵ䓊䓇烊
⚃.ġ ㊩临㗪攻⣂⮷㕤 20 䥺炻䁢ᶨ䞕㙓⿏䛤㋗烊
冢⣏慓昊㕘䪡⎘⣏↮昊俛滣┱悐
忂妲ἄ侭倗䴉嗽烉叱⣏炻冢⣏慓昊㕘䪡冢⣏↮昊俛滣┱悐炻㕘䪡ⶪ䴻⚳嶗1㭝44225嘇ˤ
E-mail: yehdawei@gmail.com
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੫ᒮ! 眩暈:從周邊到中樞ġ
10. 列⿏昋䘤⿏ỵ伖⿏䛑㘰
⎘䀋慓⬠ 2023 ⸜ 27 ⌟ 3 㛇 309
(video head impulse test, vHIT)ˣᷣ奨夾奢✪䚜䶂
(subjective visual vertical, SVV)⇵⹕婀䘤倴暣ỵ
⍵ㅱ㩊㞍(vestibular evoked myogenic potentials,
VEMP)䫱炻䘮㗗䁢Ḯ揹⇍姢㕟⎬枭⎗傥䘬㛓㡊⿏
ㆾᷕ㧆⿏䛑㘰䕦䕭ˤょ姢㕟 BPPV 㭳枰ẍᶲ₨☐炻
⛐姢攻⎒天䯉╖娊⓷䕭⎚㗗䨩䘤⿏䘬ˣ柕悐ỵ伖
㓡嬲㚱斄䘬ˣ䛑㘰㗪攻㔠䥺ㆾ㔠↮ℏ侭炻⌛⎗㆟
䔹ˤḰẍ Dix-Hallpike maneuver 冯⸛幢ᶳⶎ⎛“幢
㩊㞍䡢⭂姢㕟炻ℵ㕥ẍ㬋䡢ᷳ㱣䗪ㇳ㱽炻⌛⎗ᶵ喍
侴䗺ˤ
ठ ᖴ
䈡⇍デ嫅㕘䪡⎘⣏↮昊倥≃ⷓ⛀昲昛ὲ᷆ˣ
∱䏔Ḷ⋼≑㉵㓅⽑ỵ埻䚠䇯炻㛙朄₨⋼≑暣儎丒
⚾ˤ
ᖂ ܴ
㛔䞼䨞ᷳ⇑䙲堅䨩烉䃉ˤ䞍ね⎴シ烉䃉ˤ⍿
娎侭㪲䙲烉䃉Ṣ橼ㆾ≽䈑⮎槿ˤ
ୖԵЎ
1. Dornhoffer JL, Colvin GB. Benign paroxysmal
positional vertigo and canalith repositioning:
clinical correlations. Am J Otol 2000;21;230-3.
2. Hornibrook J. Benign paroxysmal positional
vertigo (BPPV): History, pathophysiology,
office treatment and future directions. Int J
Otolaryngol 2011;2011:835671.
3. Imai T, Takeda N, Ikezono T, et al. Classification,
diagnostic criteria and management of benign
paroxysmal positional vertigo. Auris Nasus
Larynx 2017:44:1-6.
4. Epley JM. The canalith repositioning procedure:
for treatment of benign paroxysmal positional
vertigo. Otolaryngol Head Neck Surg 1992;
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12. 列⿏昋䘤⿏ỵ伖⿏䛑㘰
⎘䀋慓⬠ 2023 ⸜ 27 ⌟ 3 㛇 311
Benign Paroxysmal Positional Vertigo
Ta-Wei Yeh
Abstract: Benign paroxysmal positional vertigo (BPPV) is the most common cause of dizziness. Posterior canal
BPPV (PC-BPPV) accounts for about 80% of all types of BPPV, can be diagnosed by Dix-Hallpike maneuver,
otolith can trigger flow of endolymphatic fluid by gravity, then cause deviation of cupula and induce upward
rotatory nystagmus. PC-BPPV can be treated by canalith repositioning procedure, such as Epley maneuver and
Sémont maneuver. Horizontal canal BPPV (HC-BPPV) accounts for about 20% of all types of BPPV, can be
diagnosed by supine to head-lateral test, geotropic nystagmus means canalithiasis of HC-BPPV, apogeotropic
nystagmus means cupulolithiasis of HC-BPPV. HC-BPPV can be treated by forced prolonged position (FPP), let
the patient lie to the weaker side of nystagmus for 10~12 hours continuously, if the patient cannot endure long
term side lying then choose other methods, such as barbecue maneuver and Gufoni maneuver. Anterior canal
BPPV (AC-BPPV) is very rare, downbeat nystagmus can be induced by Dix-Hallpike maneuver, can be treated
by deep head hanging maneuver no need to consider which side is lesion side.
Key Words: benign paroxysmal positional vertigo, nystagmus, semicircular canal, canalithiasis, cupulolithiasis,
canalith repositioning procedure
(Full text in Chinese: Formosan J Med 2023;27:300-11) DOI:10.6320/FJM.202305_27(3).0007
Department of Otolaryngology, NTU Hsin-Chu Hospital, Hsin Chu, Taiwan.
Address correspondence to: Ta-Wei Yeh, Department of Otolaryngology, NTU Hsin-Chu Hospital, No. 25, Ln. 442, Sec. 1,
Jingguo Rd., Hsinchu, Taiwan. E-mail: yehdawei@gmail.com