Semont

The Semont maneuver, also known as the liberatory maneuver, is a nonpharmacological treatment for benign paroxysmal positional vertigo (BPPV), particularly when the posterior semicircular canal is affected by free-floating otoliths (canaliths). It was developed by the French physician Adolphe Semont and is used to dislodge canaliths and move them into the utricle, where they are less likely to provoke vertigo.

The procedure involves rapid, sequential head and body movements performed by a clinician. In a typical sequence, the patient starts seated with the head turned about 45 degrees toward the affected ear. The patient is then quickly moved to a side-lying position on the opposite side, with the head oriented so the nose points upward, followed by a quick return to the seated position and then to the opposite side-lying position with the head rotated in the opposite direction. Each position is held briefly to allow the otoliths to settle, and the entire sequence may be repeated once or twice per session. The intent is to use gravity to move the debris out of the posterior canal and into the utricle.

Effectiveness reported in clinical studies varies, but the maneuver can be as effective as the Epley maneuver for posterior canal BPPV, with many patients experiencing immediate or rapid symptom relief after one or two sessions. It is less effective for non-posterior canal BPPV, such as horizontal canalolithiasis, and may cause short-term vertigo, nausea, or imbalance. Contraindications include conditions that limit safe rapid head or neck movements, severe cervical spine disease, and acute neck injuries.