Semont maneuver

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What is it and what is the Semont manoeuver used for?

The Semont Manoeuver is a method used to reposition otoliths, the structures located near the inner ear responsible for balance and acceleration. It is used to treat Benign Paroxysmal Positional Vertigo.

What is Benign Paroxysmal Positional Vertigo (BPPV)?

Benign Paroxysmal Positional Vertigo (BPPV) is a common condition that causes brief periods of vertigo triggered by changes in the position of the head that stimulate the posterior semicircular canal of the inner ear. BPPV may induce symptoms like nausea and vomit due to the false sensation of movement felt by those affected by it.

How to perform Semont's maneuver?

Let’s analyse the Semont manoeuver in 5 simple steps.

  • Step 1: The patient seats on the examination table, his/her head is turned towards the unaffected ear.
  • Step 2: While maintining the same head position, the patient lies down and looks up at the ceiling.
  • Step 3: The patient maintains this position for three minutes. Then, they swiftly return to the sitting position, keeping the head in the same position.
  • Step 4: Next, the patient lowers the head to the opposite side facing the floor and holds this position for three minutes.
  • Step 5: Finally, the patient returns to the sitting position, the head is turned back to centre.

Given that this is a delicate manoeuver, we always suggest visiting an otolaryngologist.

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Doing the Semont manoeuver at home

Liberatory manoeuvers often involve the whole body, and their movements are so delicate and precise that patients need the support of an expert. For this reason, we do not encourage performing the Semont manoeuver at home, and instead recommend visiting an otolaryngologist.

What are the risks or side effects?

Adverse effects following a repositioning manoeuver are rare. Among them are the conversion of Benign Paroxysmal Positional Vertigo from the posterior semicircular canal to the lateral one and a possible lasting postural instability.

What not to do after Semont's manoeuver

Following a Semont maneuver, the patient must pay attention to the movements of their neck, avoiding flexions and extension for at least two days.

How to sleep after Semont's manoeuver

The two following days after the Semont manoeuver are the most important, therefore it is important to sleep in a correct position: semi-sitting position, with the back inclined at 45° angle to the horizontal plane. From the third to the tenth day, gradually decrease the inclination of the neck until the patient is supine. 

See a doctor to perform the maneuver

If you are experiencing symptoms or undergoing delicate manoeuvers, like the Semont manoeuver, it is be st to consult an otolaryngologist.

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Maneuvers and exercises for vertigo and labyrinthitis

In addition to Semont manoeuver, there are two other liberatory techniques to treat Benign Paroxysmal Positional Vertigo (BPPV) in an efficient way: the Epley manoeuver and the Brandt-Daroff exercises.

Epley manoeuver

Epley manoeuver is a repositioning treatment designed to slowly guide otoliths from the posterior semicircular canal to the utricle in order to alleviate symptoms associated with Benign Paroxysmal Positional Vertigo that may result from the Semont manoeuve.

Brandt-Daroff exercises

The Brandt-Daroff exercises are a part of l iberatory manoeuvers used to treat Benign Paroxysmal Positional Vertigo. They are a series of controlled movements to be performed two or three times a day until the symptoms disappeared.

FAQs about the Semont manoeuver

How does it feel after Semont's manoeuver?

Semont manoeuver is classified as a liberatory manoeuver because, if it is successful, the patient may experience “liberatory vertigo”: a brief episode of vertigo where the rotation of the external environment is opposite to that experienced during a vertigo episode. Its name derives from the release of otoliths from the cochlea.

What is the best manoeuver for dizziness?

Semont manoeuver, Epley manoeuver and the Brandt-Daroff exercises are highly effective techniques for alleviating Benign Paroxysmal Positional Vertigo symptoms. However, the Epley manoeuver provides an immediate sense of relief in 90% of cases.

Are there other remedies for VPPB?

Before the various treatment options for Benign Paroxysmal Positional Vertigo (BPPV), it is best to consult a professional for an accurate diagnosis. Based on the symptoms and the patient's condition, the otolaryngologist will recommend the most suitable treament, which may involve the Semont manoeuvre, the Epley manoeuvre or the Brandt- Daroff exercises. The specialist may also compliment the treatment with pharmacological therapy which can include with cortisones, antihistaminic or neuroleptics.
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