Randomized clinical trial for geotropic horizontal canal benign paroxysmal positional vertigo

Area of Science:

• Neurology
• Otolaryngology
• Vestibular System Disorders

Background:

• Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo.
• Geotropic horizontal canal BPPV (HC-BPPV) is a specific subtype requiring targeted treatment.
• The efficacy of specific maneuvers for HC-BPPV requires robust clinical validation.

Purpose of the Study:

• To compare the therapeutic efficacies of barbecue rotation and Gufoni maneuvers against a sham maneuver for geotropic HC-BPPV.
• To evaluate both immediate and long-term treatment outcomes.
• To provide Class I evidence for treatment effectiveness.

Main Methods:

• A randomized, prospective, sham-controlled study was conducted across 10 dizziness clinics in Korea.
• 170 patients with geotropic HC-BPPV were assigned to barbecue rotation (n=56), Gufoni (n=64), or sham (n=50) maneuvers.
• Immediate response was assessed within 1 hour, with 1-month follow-up for cumulative effects.

Main Results:

• Barbecue rotation (69.1%) and Gufoni (60.9%) maneuvers demonstrated significantly better immediate responses than the sham maneuver (35.4%).
• Both active maneuvers showed superior cumulative therapeutic effects over 1 month compared to the sham.
• No significant difference in efficacy was found between barbecue rotation and Gufoni maneuvers for immediate or long-term outcomes.

Conclusions:

• Barbecue rotation and Gufoni maneuvers are effective treatments for geotropic HC-BPPV.
• These maneuvers offer significant improvements over sham treatments for this vestibular disorder.
• The study provides strong clinical evidence supporting these therapeutic interventions.