A new treatment (the affected-ear-up 90° maneuver) for benign paroxysmal positional vertigo of the lateral semicircular canal.
Background: Although several researchers have tried various kinds of canalith repositioning procedures for lateral canalolithiasis, a standard treatment has not been established. We have adopted 90° rotation, which is anatomically appropriate. Objective: To clarify the efficacy of the affected-ear-up 90° maneuver. Materials and methods: The subjects were 23 consecutive patients (15 females, 8 males) who revealed transient direction-changing geotropic positional nystagmus. After determining the affected side, we immediately performed the canalith repositioning procedure. To perform this maneuver: (1) Place the patient in the supine position. (2) Rotate the head toward the healthy side until 90° from the supine. (3) Sit up. (4) Ask the patient to remain upright with the chin down until going to bed. Results: Nineteen patients (83%) became symptom-free by only one maneuver. However, three patients converted to ipsilateral cupulolithiasis of the lateral canal, and one patient required a second maneuver. Conclusion: The affected-ear-up 90° maneuver is effective against lateral canalolithiasis.
['Ichijo|Hiroaki|H|']
D000328:Adult D000368:Aged D065635:Benign Paroxysmal Positional Vertigo D015331:Cohort Studies D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009760:Nystagmus, Physiologic D010036:Otolaryngology D056888:Patient Positioning D011187:Posture D011446:Prospective Studies D012399:Rotation D012665:Semicircular Canals D016896:Treatment Outcome
Canalolithiasis positional nystagmus cupulolithiasis Ewald’s second law lying-down nystagmus