title: Success of the modified Epley maneuver in treating benign paroxysmal positional vertigo.
abstract: OBJECTIVE
  Benign paroxysmal positional vertigo (BPPV) is a common condition seen by otolaryngologists. The purpose of this study is to determine the ability of the modified Epley maneuver to treat BPPV.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  A retrospective chart review of 107 patients diagnosed with BPPV at our institution between March of 1993 and June of 1995. Each patient was diagnosed with isolated BPPV by history and Hallpike-Dix maneuver. There were no other vestibular symptoms or electronystagmogram abnormalities. Patients diagnosed with BPPV received modified Epley maneuvers, were instructed to remain upright for 48 hours, and wore a soft collar for a week. Patients were followed up with repeat Hallpike-Dix maneuvers at 1 to 2 weeks. If symptoms persisted, the maneuver was repeated for up to a maximum of three times, at which point patients were considered to have failed treatment.
  
  
  RESULTS
  The average age of patients was 57.8 years old. Thirty percent were male and the right ear was affected in 54%. The posterior semicircular canal was affected in 105 ears. The average patient received 1.23 Epley maneuvers, with a success rate of 93.4%. No successfully treated patients received mastoid vibration. Seven out of 107 patients failed after three Epley maneuvers. Two failure patients had a history of temporal bone fracture. Two failure patients were treated with posterior semicircular canal block surgery.
  
  
  CONCLUSIONS
  The modified Epley maneuver is an excellent treatment for BPPV.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, University of Maryland Medical System, Baltimore, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Wolf
authors.forename: K P
authors.initials: KP
authors.lastname: Boyev
authors.forename: B J
authors.initials: BJ
authors.lastname: Manokey
authors.forename: D E
authors.initials: DE
authors.lastname: Mattox
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D026741:Physical Therapy Modalities / Q000379:methods*; D011187:Posture; D012008:Recurrence; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome; D014717:Vertigo / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D014724:Vestibular Function Tests