Rebalancing the Inner Ear: Tracking Epley's Maneuver Success Through Subjective Visual Vertical

Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder, predominantly affecting the posterior semicircular canal. While the Epley maneuver is widely recognized as the first-line treatment, objective tools for assessing treatment success are limited. Subjective Visual Vertical (SVV) offers a means to evaluate utricular function and may provide objective evidence of therapeutic response.

To evaluate the efficacy of the Epley maneuver in treating posterior canal BPPV using SVV as an objective outcome measure.

A prospective observational study was conducted on 143 patients (20-65 years) with posterior canal BPPV confirmed by the Dix-Hallpike maneuver. All patients underwent SVV testing before and after the Epley maneuver. Clinical outcomes included SVV deviation, recurrence, and correlations with symptom duration and relief.

The mean patient age was 42.15 ± 14.42 years. Significant improvement in SVV deviation was observed across static and dynamic head positions after the Epley maneuver (P < 0.05). Recurrence was noted in 2.1% of cases. Symptom relief occurred within 14.59 ± 6.28 days. A strong positive correlation (r = 0.706) was found between symptom duration and dynamic clockwise SVV deviation.

The Epley maneuver is a highly effective treatment for posterior canal BPPV with a low recurrence rate. SVV serves as a valuable, objective tool for assessing utricular function and monitoring treatment response.