From the Guidelines
The Semont maneuver, also known as the canalith repositioning procedure, is a highly effective treatment for benign paroxysmal positional vertigo (BPPV) that involves a series of specific head and body movements to relocate displaced calcium carbonate crystals in the inner ear. To perform the Semont maneuver, the patient starts by sitting on a table or flat surface with their head turned away from the affected side 1. The steps involved in the Semont maneuver are as follows:
- The patient is quickly moved into a side-lying position toward the affected side, with their head turned up, and this position is held for at least 20 seconds after all nystagmus has ceased 1.
- The patient is then quickly moved back up and through the sitting position to the opposite side-lying position, without changing their head position relative to their shoulders, and this position is held for about 30 seconds 1.
- Finally, the patient is slowly brought back up to the sitting position 1. The Semont maneuver works by using gravity and inertial forces to move the displaced crystals out of the affected semicircular canal and back into the utricle, thereby relieving the vertigo symptoms 1. It is essential to note that the Semont maneuver may cause brief vertigo during the procedure, but this indicates that the treatment is working 1. Additionally, the maneuver is generally safe, with mild and self-limiting adverse effects occurring in about 12% of patients, and serious complications are rare 1. The Semont maneuver should be performed by a healthcare provider initially, and patients can learn to do a modified version at home if needed 1. Multiple treatments may be necessary for complete resolution of symptoms, and patients should be informed about the potential risks and benefits of the procedure 1.
From the Research
Definition and Purpose of the Semont Maneuver
- The Semont maneuver, also known as the canalith repositioning procedure, is a treatment for benign paroxysmal positional vertigo (BPPV) [(2,3,4,5,6)].
- The purpose of the Semont maneuver is to relocate the calcium particles (canaliths) in the inner ear that cause the vertigo [(2,3,4,5,6)].
Efficacy of the Semont Maneuver
- Studies have shown that the Semont maneuver is an effective treatment for BPPV, with a high success rate [(2,3,4,5)].
- A study published in 1996 found that 62% of patients were freed of the disorder after a single maneuver, and 95.5% after 3 treatments 2.
- Another study published in 2017 found that the modified Semont maneuver had a short-term efficacy rate of 91.7% and 98.3% at 3 days and 1 week after treatment, respectively 4.
- A double-blind randomized trial published in 2012 found that the Semont maneuver was highly effective in treating posterior canal BPPV, with a recovery rate of 79.3% and 86.8% at 1 and 24 hours after treatment, respectively 5.
Comparison with Other Treatments
- The Semont maneuver is considered a first-line treatment for BPPV, along with other canalith repositioning maneuvers such as the Epley maneuver [(3,6)].
- A study published in 2017 found that the modified Semont maneuver was as effective as the Epley maneuver in treating posterior canal BPPV 4.
- The Semont maneuver is generally considered to be a simple and effective treatment for BPPV, with a low risk of complications [(2,3,4,5,6)].