Vibration with the canalith repositioning maneuver: a prospective randomized study to determine efficacy.
OBJECTIVE
The objective was to determine whether the inclusion of vibration and additional treatment cycles has an effect on short- and long-term success rates in the treatment of benign paroxysmal positional vertigo with the canalith repositioning maneuver.


METHODS
Prospective randomized study of patients treated at a tertiary vestibular rehabilitation center.


METHODS
Variables identified for statistical analysis included patient age, gender, vibration used, and canalith repositioning cycles. Analysis using Student t test, chi2 test, Kaplan-Meier curves with log rank test, and Cox proportional hazards regression was performed.


RESULTS
One hundred two patients with benign paroxysmal positional vertigo treated over a 1-year period (August 2001-August 2002) were randomly assigned to receive the canalith repositioning maneuver with or without vibration. Average duration of follow-up was 9.44 months. The single treatment success rate was 93.1%. To relieve symptoms, 29.4% of patients required more than one canalith repositioning cycle. The relapse rate was 30.5%. Thirty-nine patients were assigned to the canalith repositioning group with vibration, and 63 to the canalith repositioning group without vibration. There was no statistical difference in age, gender, initial success rates, or relapse rates between the canalith repositioning groups with and without vibration. On average, patients required 1.38 canalith repositioning cycles for successful treatment. Vibration did not affect the number of canalith repositioning cycles required to convert the Dix-Hallpike test result to normal. The need for additional canalith repositioning cycles had no statistical effect on initial treatment success or relapse rates.


CONCLUSIONS
Vibration provided no additional benefit in initial treatment success or in reducing long-term relapse rates when included in the canalith repositioning maneuver. Many patients with benign paroxysmal positional vertigo require more than one canalith repositioning cycle at the time of initial treatment to relieve symptoms, but this does not indicate a higher likelihood for recurrence. No variable predicted a higher rate of recurrence.
Macias
John D
JD
Macias Otology, Banner Good Samaritan Rehabilitation Institute, Phoenix, Arizona, USA.
Ellensohn
Andrea
A
Massingale
Shelly
S
Gerkin
Richard
R
D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture; D016016:Proportional Hazards Models; D011446:Prospective Studies; D016896:Treatment Outcome; D014717:Vertigo / Q000628:therapy*; D014732:Vibration / Q000627:therapeutic use*