By Marcello Cherchi, MD PhD
A modification of the Semont maneuver, called the Semont plus maneuver, was described by Dr. Michael Strupp and colleagues. This appeared superior to the regular Semont maneuver (Strupp et al. 2021), and superior to the Epley maneuver (Strupp et al. 2023).
The Figure below, modified from Strupp and colleagues (Strupp et al. 2021), shows the Semont plus maneuver for treating right-sided posterior canal BPPV.
The following description of this maneuver is adapted from that of Strupp and colleagues (Strupp et al. 2021):
- Sitting up, neutral position.
- Sitting up, head turned 45 degrees toward the patient’s unaffected (left) side.
- Movement of the head by 150 degrees toward the patient’s affected (right) side. This moves the otoliths farther along the direction in which they should move (“B+”).
- Since the otoliths are beyond the vertex, the movement of the body by 240 degrees toward the patient’s unaffected (left) side moves the otoliths in direction “C+” toward the ampulla.
- Sitting up, neutral position. The otoliths fall into the ampulla (“D+”).
Semont plus maneuver, right posterior canal, videos
- https://www.youtube.com/watch?v=2i2aPW0iMxA
- https://edhub.ama-assn.org/jn-learning/video-player/18794329
The Semont plus maneuver has been studied against the (regular) Semont maneuver in multiple randomized controlled trials (Strupp et al. 2021; Strupp et al. 2023).
References
Strupp M, Goldschagg N, Vinck AS, Bayer O, Vandenbroeck S, Salerni L, Hennig A, Obrist D, Mandala M (2021) BPPV: Comparison of the SemontPLUS With the Semont Maneuver: A Prospective Randomized Trial. Front Neurol 12: 652573. doi: 10.3389/fneur.2021.652573
Strupp M, Mandala M, Vinck AS, Van Breda L, Salerni L, Gerb J, Bayer O, Mavrodiev V, Goldschagg N (2023) The Semont-Plus Maneuver or the Epley Maneuver in Posterior Canal Benign Paroxysmal Positional Vertigo: A Randomized Clinical Study. JAMA Neurol 80: 798-804. doi: 10.1001/jamaneurol.2023.1408
