الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
BPPV occurs as a result of detachment of otoconia from the otolithic membrane and their collection in one of the SCCs. Repositioning maneuvers can be used to treat BPPV promptly and effectively. The goal of those maneuvers is to promote the passage the calcium particles from the area in the SCCs where they are triggering the vertigo into the area in the ear where they normally belong.
However, in some patients, residual symptoms may remain even after disappearance of typical vertigo and nystagmus following a successful CRPs.(95) Residual Dizziness (RD), include non-positional, sustained imbalance of variable duration. The duration of RD has been evaluated by different authors in a range varying from 2 days to 3 weeks.(106)
Several theories were proposed to explain the presence of RD after successful maneuvers as follows:
First, the persistence of otoconial debris due to incomplete repositioning could produce mild positional vertigo, where the remaining debris is insufficient to provoke noticeable positional nystagmus.
Second, BPPV is not only a disorder of the semicircular canals but also a disorder of the otoliths, and otolith dysfunction might account for transient dizziness.
Third, another vestibular lesion which is difficult to identify from the history and clinic examination might coexist with BPPV.
Fourth, delayed recovery might be due to the longer time needed for central adaptation after particle repositioning.
Fifth, a possible correlation between the duration of vertigo (i.e. the time in days between the onset of positional vertigo and repositioning maneuvers) and the occurrence of RD. However the severity of postural instability estimated after repositioning maneuver depended on the disease duration of BPPV (64-66)
These hypotheses, although theoretically valid, have not yet been supported by definitive data.(109,110)
SOT can be utilized to assess the efficiency of repositioning maneuvers in BPPV differentiating spontaneous recovery of BPPV patients from recovery due to successful repositioning maneuvers. This is centered on a simple explanation that if more otoconia are successfully reattached to the utricular maculae after repositioning maneuver, there will be an improvement in somatosensory, vestibular and visual components of SOT and SOT can help to detected any postural instability in BPPV patient’s .
The target of this study was to evaluate the posturographic changes in patients with BPPV before and after a repositioning maneuver.
The study was conducted on 20 patients with idiopathic BPPV with no age or gender restrictions and normal peripheral hearing sensitivity in the audiology unit of Alexandria main university hospital.
Comparing of SOT at three time points: comparing between cases before and one week after repositioning maneuver, comparing between cases before and controls and comparing between case after repositioning maneuver and control.
Our results that BPPV patients showed improvement in Sensory balance scores when compare before and after repositioning maneuver but sensory balance scores were significantly worse when compared to controls specially in vestibular and somatosensory system.