By Marcello Cherchi, MD PhD
The Semont maneuver, originally described by Dr. Alain Semont and colleagues (Semont et al. 1988) for treating the posterior canal, can be “modified” (effectively, reversed in its sequence of positions) for treating the anterior canal when the side is known. This is one of the more common maneuvers for treating anterior canal BPPV.
The Figure below, from Asprella Libonati (Asprella Libonati 2012), is labeled the “Vanucchi maneuver,” but appears instead to be depicting the modified (reversed) Semont maneuver for right-sided anterior canal BPPV.
The description of the modified (reversed) Semont maneuver for treating right-sided anterior canal BPPV is as follows:
- The patient starts in a neutral seated position.
- The head is turned 45 degrees toward the patient’s affected (right) side.
- The patient quickly lies down on the affected (right) side, with the head still turned 45 degrees toward the patient’s unaffected (left) side (which is to say that nose is pointing half-way between the plane of the earth and the ground), and maintains this position for 1 minute.
- The patient quickly flips the entire torso on to the patient’s unaffected (left) side, keeping the head rotated 45 degrees toward the patient’s affected (right) side (which is to say that the patient’s nose is pointing half-way between the plane of the earth and the sky), and maintains this position for 1 minute.
- The patient slowly returns upright to a neutral seated position.
Semont maneuver, modified (reversed), right anterior canal, videos
- https://www.youtube.com/watch?v=WtImIEvaa1I (Wendy Carender, University of Michigan)
- https://www.youtube.com/watch?v=N32UCyULjRA (Boys Town)
References
Semont A, Freyss G, Vitte E (1988) Curing the BPPV with a liberatory maneuver. Adv Otorhinolaryngol 42: 290-3. doi: 10.1159/000416126
