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Randomized clinical trial for geotropic horizontal canal benign paroxysmal positional vertigo

2012; Lippincott Williams & Wilkins; Volume: 79; Issue: 7 Linguagem: Inglês

10.1212/wnl.0b013e3182648b8b

1526-632X

Ji Soo Kim, Sun‐Young Oh, Seung‐Han Lee, Ji‐Hoon Kang, Dong Uk Kim, Seong‐Hae Jeong, Kwang‐Dong Choi, In Soo Moon, Byung‐Kun Kim, Hyo Jung Kim,

Neuroscience of respiration and sleep

Objectives: To determine the immediate and long-term therapeutic efficacies of barbecue rotation and Gufoni maneuvers, a randomized, prospective, and sham-controlled study was conducted in patients with the geotropic type of benign paroxysmal positional vertigo involving the horizontal semicircular canal (HC-BPPV). Methods: In 10 nationwide dizziness clinics in Korea, 170 consecutive patients (107 women, age range 11−97 years, mean age ± SD 61 ± 15 years, median = 61 years) with geotropic HC-BPPV were randomly assigned to barbecue rotation (n = 56), Gufoni (n = 64), or sham maneuver (n = 50). An immediate response was determined within 1 hour after a maximum of 2 trials of each maneuver on the visit day. We also assessed the cumulative results of each maneuver by following up the patients for 1 month. Results: After a maximum of 2 maneuvers on the initial visit day, barbecue rotation (38 of 55 [69.1%]) and Gufoni (39 of 64 [60.9%]) maneuvers showed better responses than the sham maneuver (17 of 48 [35.4%]). The cumulative therapeutic effects were also better with barbecue rotation ( p = 0.006) and Gufoni ( p = 0.031) maneuvers than with the sham maneuver. However, therapeutic efficacies did not differ between the barbecue rotation and Gufoni groups in terms of both immediate ( p = 0.46) and long-term ( p = 0.10) outcomes. Conclusion: Using a prospective randomized trial, we demonstrated that barbecue rotation and Gufoni maneuvers are effective in treating geotropic HC-BPPV. Classification of evidence: This study provides Class I evidence that barbecue rotation and Gufoni maneuvers are effective in the treatment of geotropic HC-BPPV.