Treatment of Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo

Study Overview
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Brief Summary
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To determine the short term therapeutic efficacies of Gufoni maneuver and mastoid oscillation in apogeotropic type of benign paroxysmal positional vertigo (BPPV) involving the horizontal semicircular canal (HC-BPPV), a randomized, prospective, sham-controlled study was conducted.

Detailed Description
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The apogeotropic type of benign paroxysmal positional vertigo involving the horizontal canal (HC-BPPV) is likely due to otolithic debris in the anterior arm of the canal (canalithiasis) or the debris attached to the cupula (cupulolithiasis). It is important to seek the method to convert treatment-resistant apogeotropic form to the more treatment-responsive geotropic form in HC-BPPV. Recent randomized trials demonstrated that head shaking maneuver was more effective than the modified Semont maneuver and the Gufoni and head shaking maneuvers showed similar efficacy in treating apogeotropic HC-BPPV. Moreover, new repositioning maneuver using mastoid vibration showed good efficacies in patients with apogeotropic HC-BPPV in recent study. So we tried to compare the short term therapeutic efficacies of Gufoni maneuver and mastoid oscillation in apogeotropic HC-BPPV with a randomized, prospective, sham-controlled study.

Conditions
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Benign Paroxysmal Positional Vertigo

Intervention / Treatment
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* Procedure: Gufoni
* Procedure: Vibration
* Procedure: Sham


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: history of vertigo associated with changes in head position direction-changing horizontal nystagmus beating toward the uppermost ear (apogeotropic nystagmus) in both turning positions detected with Frenzel glasses or videoculography in the Head turning test vertigo associated with the elicited nystagmus symptom within 2 weeks put one's signature on consent Exclusion Criteria: patients with identifiable central nervous system disorders that could explain the positional vertigo and nystagmus the patients with apogeotropic form which was transited from geotropic after previous therapeutic maneuvers the patients who transited from apogeotropic from vertical canal BPPV during study patients who had possible cause of secondary BPPV such as Meniere's disease, migraine or recent trauma history patients whose affected ear cannot be identified patients with multiple canal atypical positional nystagmus or who were treated previously with repositioning maneuvers were excluded. patients with cervical or lumbar spine problem

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Gufoni<br>Gufoni maneuver for apogeotropic horizontal BPPV at the first day | Procedure: Gufoni<br> <br> |
| Experimental: Vibration<br>Vibration maneuver for apogeotropic horizontal BPPV at the first day | Procedure: Vibration<br> <br> |
| Sham Comparator: Sham<br>Sham maneuver for apogeotropic horizontal BPPV at the first day | Procedure: Sham<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Conversion in Direction of Nystagmus From Apogeotropic to Geotropic or Disappearance of Nystagmus |  | 2 days |