Efficacy of the barbecue manoeuvre in benign paroxysmal vertigo of the horizontal canal

Abstract

Five to ten percent of benign paroxysmal positional vertigo are caused by the horizontal semi-circular variant (h-BPPV). In this study, we reviewed the eYcacy of the Barbecue repositioning manoeuvre in h-BPPV, and we assessed the possible eVect of diVerent factors on the outcome. Barbecue manoeuvre consists in turning the supine patient around his longitudinal axis toward the unaVected side until 360° are accomplished. After every 90° step the patient is maintained in the new position for 30 s. We reviewed 46 patients with h-BPPV, treated by barbecue rotation from 2003 to 2005. After the Wrst Barbecue manoeuvre, the patients were followed-up at intervals of approximately 1 week and the rotation was repeated if h-BPPV persisted (up to three rotations). Factors assessed were age, gender, duration of symptoms before treatment and type of h-BPPV (canalolithiasis vs. cupulolithiasis). Fisher's exact test was used for the analysis. Results: 85% of patients (39/46) were cured after a maximum of 3 rotations. 74% (34/46) were cured after the Wrst manoeuvre and 80% (37/46) after the second one. None of the evaluated factors did signiWcantly aVect the eYcacy (P > 0.05). The Barbecue manoeuvre is an eYcient treatment of h-BPPV demonstrating 85% cure rate after a maximum of three sessions. 74% of the patients are healed after one manoeuvre. The eYcacy is not aVected by the evaluated factors.

Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo: Effectiveness of Two Different Methods of Treatment

“…For the treatment of HSC-BPPV, the barbecue maneuver (and its several variations) is the one that is most commonly used [Fife, 1998;White et al, 2005;Escher et al, 2007], often in association with FPP [Nuti et al, 1998;Casani et al, 2002;Koo et al, 2006] achieving success in 50-100% of the cases. Some years ago, Gufoni et al [1998] described a method of treatment that involves shifting the patient rapidly from a sitting position to the healthy side (in the geotropic forms) or to the affected side (in the apogeotropic forms).…”

Efficacy of the “bow and lean test” for the management of horizontal canal benign paroxysmal positional vertigo

“…2,9,14 Therefore, if the determination of the affected ears and types could be determined more accurately, the remission rate for HSC-BPPV might improve.…”

Benign paroxysmal positional vertigo and orthostatic hypotension

“…In each patient, diagnosis was carried out by means of Dix-Hallpike and Semont maneuvers for posterior canal BPPV and by means of the Pagnini-McClure maneuver [5] for lateral canal BPPV. Fourteen patients (48%) were affected by hypertension treated with antihypertensive drugs (various combination of ace-inhibitors, Ca-antagonist, diuretics, and b-blockers), of these 12 were taking 2 or more drugs.…”

“…All patients affected by posterior canal BPPV were treated with Semont RM [22]; two patients with horizontal canal involvement underwent Lempert's barbecue maneuver, an RM consisting in body rotation of 270°; this rotation was performed in the supine position toward the healthy side in steps of 90° [5].…”

“…The same study shows that the incidence of BPPV increases with age, with a mean age of onset of 49 years, and that it is more common in women, with a ratio of 2.4. BPPV therapy is based on repositioning maneuvers (RM), with a cure rate of up to 90% in patients with posterior semicircular canal involvement [13], and 85% in those with lateral semicircular canal involvement [5].…”