Benign Paroxysmal Positional Vertigo: 16-Year Experience

Objective To assess the short and long‐term efficacy of canalith repositioning procedure (CRP) in the treatment of patients with benign paroxysmal positional vertigo (BPPV). Method Nine hundred sixty‐five patients (481 men and 484 women, from 18 to 84 years old) were enrolled in this prospective study during 1995‐2010. Inclusion criteria were patient history compatible with BPPV and positive provocative maneuver (either Dix‐Hallpike or Roll test). Reported duration of symptoms at the time of their first examination varied from 1 day to 18 months. A variant of Epley and Barbeque maneuver was used. The Epley maneuver was used for posterior and anterior canal involvement, and “Barbeque roll” was used for horizontal canal involvement. Short‐term follow‐up was obtained 48 hours and 7 days after initial treatment, whereas long‐term follow‐up was obtained at repeated 6 month intervals. Results The posterior semicircular canal was involved in 849 (88%) patients treated, whereas the horizontal and anterior semicircular canals were involved in 96 (10%) and 20 (2%) patients, respectively. Symptoms subsided immediately in 819 patients (85%) by the first CRP. Only 19 patients (2%) required CRP more than 3 times. Patients’ mean follow‐up was 72 months; symptom recurrence was noted in 135 patients. The great majority of them were elderly patients (n = 33) or had a history of either vestibular neuropathy (n = 27) or head trauma (n = 58). Conclusion Our data, based on long‐term follow‐up, suggest that CRP remains an efficient and long‐lasting noninvasive treatment for BPPV.