The utility of the TRV Chair in BPPV patients

The TRV Chair lends itself toward the diagnosis and treatment of Benign Paroxysmal Positional Vertigo (BPPV), which is one of  the most common forms of dizziness.

Måns Magnusson, M.D., Professor at the Otorhinolaryngology Department at Lund University, has researched the applications of the TRV Chair since 2013.

Interacoustics spoke with Professor Magnusson to learn the fruits of his research.

When did you acquire the TRV Chair?

We acquired the chair about seven years ago.

After installing it in the clinic, we have been using it in patients for almost seven years.

What have you learned using the TRV Chair?

We have learned a lot using the chair.

There is more to BPPV than we thought to begin with.

Firstly, we have experienced patients with BPPV or problems in more than one canal even if one canal is dominating.

Secondly, we have experienced patients with a combination of lesions, where BPPV might be one of them.

Thirdly, we have been able to use the TRV Chair to treat patients with cervical problems, spinal stenosis and rheumatoid arthritis.

So, the benefits are two-fold from our perspective and the perspective of the patient.

Is the TRV Chair purely therapeutic?

Quite often we receive patients that we suspect have BPPV.

In saying suspect, we do not know if BPPV is the major problem or part of the problem.

In that case, we can test all the different canals in a proper way and conclude on a diagnosis.

Thus, the TRV Chair is not only a therapeutic tool but also a diagnostic tool, which was an unexpected benefit.

In some cases where patients have not benefited from previous repositioning treatments, testing with the TRV Chair sometimes returns a suspicion on a central nervous disorder or a combination of BPPV and a central nervous disorder.

In these cases, this testing has turned out to be very useful.

Måns Magnusson has used the TRV Chair for several years in his clinic at Lund University.

How does the TRV Chair compare to traditional repositioning maneuvers?

BPPV is a common lesion that produces a lot of patients.

You can treat most of these patients on a couch at the clinic.

Yet, there are certain patient populations that you cannot treat in this manner.

Taking the large BPPV-patient population into consideration, there are a lot of people who cannot be rehabilitated using traditional maneuvers.

This is where the TRV Chair becomes a very important tool.

Which benefits does the TRV Chair offer?

The TRV Chair offers both benefits and drawbacks, as does any test method.

Looking at the benefits, the TRV Chair can perform proper movements for all affected canals or combinations of canals.

It can perform these movements in difficult-to-treat patients, such as elderly or obese patients or patients with cervical or spinal problems.

Without the comfort of TRV Chair, which does not need patient cooperation, these patients could be difficult or impossible to assess.

Compared with traditional maneuvers, it must be said that the TRV Chair takes more time per patient.

But if we reduce its use to above-mentioned patients, this is not a problem at all.

Have you researched any diagnostic applications of the TRV Chair?

One of my favorite applications is that you can separate patients with central nervous disorders from those with peripheral vestibular disorders of BPPV.

The benefit being that a patient could have positional nystagmus of a central nervous origin and BPPV at the same time.

This is one among many diagnostic applications of the TRV Chair.

Måns Magnusson, M.D., is a Professor at the Otorhinolaryngology Department at Lund University, Sweden. Since 2005, the Deputy Director of the Department of Clinical Sciences, including the role as Director of Neuroscience, Senses, and Psychiatry. He is Chairman of the Recruiting Board at the Medical Faculty of Lund University.