The Effect of Canalith Repositioning for Anterior Semicircular Canal Canalithiasis

Abstract

The purpose of this study was to evaluate the efficacy of our canalith repositioning procedure (CRP) for benign paroxysmal positional vertigo (BPPV) of the anterior semicircular canal (ASC). We conducted a prospective study of 30 ASC BPPV patients to analyze the efficacy of a modified CRP. When the patient was diagnosed as having ASC BPPV by a specific provocative positioning test, a CRP was performed. The response to the treatment was categorized as grade I–IV. Of the 30 study patients, 6 were male and 24 were female with the highest incidence when the patients were in their 50s. The vertigo and nystagmus in 29 patients fully resolved (grade I). Using this maneuver, 96.7% of patients became symptom free. Overall, the maneuver needed to be performed 1.97 times to control the symptoms. Based on these findings, CRP could be one of the most effective treatment methods for ASC BPPV.

Efficiency of the Deep Head Hanging Maneuver for Anterior Canal Benign Paroxysmal Positional Vertigo

“…The results from the current study indicated that the DH maneuver was successful in clearing ASC BPPV. The purpose of the DH maneuver was to remove physically the otoconia from the SCC and relocate them back into the utricle using gravity and a systematic progression of head position changes 4,10) . Approximately 95% of patients were clear within one or two treatments, and less than 5% of the patients required a third treatment session.…”

“…Yacovino et al (2009) reported that all cases showed excellent therapeutic response to the DH maneuver 13) . Kim et al (2005) reported that vertigo and nystagmus in 29 patients were fully resolved using this maneuver and that 96.7% of patients became symptom free 10) . Based on these findings and our results, the DH maneuver could be one of the most effective treatment methods for ASC BPPV.…”

“…The clinician can determine the SCC involved by analyzing the eye movements provoked and the latency of the nystagmus 2) . ASC BPPV is characterized by paroxysmal down-beating nystagmus lasting less than 60 seconds 10,11) . The most common clinical intervention for canalithiasis of the ASC is the canalith-repositioning maneuver (CRM).…”

“…Because the ASC has a different trajectory from the PSC, maneuvers targeting ASC BPPV differ geometrically from those described by Epley for PSC BPPV 12) . The idea of the DH maneuver is to invert the ASC to allow debris to fall to the "top" of the ASC, and then, upon returning the patient to the sitting position, allow it to migrate further into the common crus and then the utricle 10) . The purpose of the current investigation was to determine whether the DH maneuver is an efficacious treatment maneuver for ASC BPPV.…”

Treatment of benign paroxysmal positional vertigo

“…Модифицированный репозиционный маневр при ДППГ ППК заключается в следующем: пациент усажива-ется на кушетку, его голова поворачивается на 45° в непо-раженную сторону [25]. Далее он укладывается на спину, не изменяя разворот головы, но глубоко запрокидывая ее назад на 30° (по возможности на 45°) ниже горизонталь-ной плоскости и удерживается в этом положении 2 мин.…”