Treatment of horizontal canal BPPV: pathophysiology, available maneuvers, and recommended treatment

Yahav Oron, Smadar Cohen-Atsmoni, Assaf Len, Yehudah Roth
Laryngoscope 2015, 125 (8): 1959-64

OBJECTIVES/HYPOTHESIS: To describe the pathophysiology of horizontal canal benign paroxysmal positional vertigo, the available maneuvers for its management, and the recommended treatment.

DATA SOURCES: PubMed, Cochrane library.

REVIEW METHODS: Review of the available literature.

RESULTS: Two theories of pathophysiology underlying the disease are described, along with available maneuvers reflecting those theories; and videos of the maneuvers are provided. A comparison of available treatments is made.

CONCLUSION: A variety of maneuvers is available related to the pathophysiology underlying the disease. The treatment chosen should be appropriate to the patients' ages, general conditions, and other diseases they may have. No treatment was found to be superior over the others regarding the success rate. In the case of geotropic nystagmus, the Gufoni maneuver is superior in its ease of performance. When it comes to apogeotropic nystagmus, the Barbecue and Gufoni maneuvers have comparable success rates.

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