Treatment for BPPV, anterior canal, left side, modified Semont maneuver

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.

The Figure below depicts the modified (reverse) Semont maneuver for left-sided anterior canal BPPV.

The description of the modified (reversed) Semont maneuver for treating left-sided anterior canal BPPV is as follows:

1. The patient starts in a neutral seated position.
2. The head is turned 45 degrees toward the patient’s left (affected) side.
3. The patient quickly lies down on the left (affected) side, with the head still turned 45 degrees toward the patient’s left (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.
4. The patient quickly flips the entire torso on to the patient’s right (unaffected) side, keeping the head rotated 45 degrees toward the patient’s left (affected) 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.
5. The patient slowly returns upright to a neutral seated position.

Semont maneuver, modified (reversed), left anterior canal, videos

• https://www.youtube.com/watch?v=qDnh5NyAEAc (Wendy Carender, University of Michigan)
• https://www.youtube.com/watch?v=JECN5etGM8Y (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