title: Benign paroxysmal positional vertigo: 10-year experience in treating 592 patients with canalith repositioning procedure.
abstract: OBJECTIVE
  To assess the long-term efficacy of canalith repositioning procedure (CRP) in the treatment of patients with benign paroxysmal positional vertigo (BPPV).
  
  
  BACKGROUND
  Alternative theories for the pathophysiology of BPPV have been redefined in the past few years. CRP is considered to be the standard technique for its management. However, long-term follow-up results have been minimally reported in the literature.
  
  
  METHODS
  Five hundred ninety-two patients, 290 (49%) men and 302 (51%) women, were enrolled in this prospective study; their ages ranged from 18 to 84 (mean 59) years. At the time of their first examination, patients reported the duration of symptoms varied from 1 day to 18 months. Inclusion criteria were patient history compatible with BPPV and positive provocative maneuver (either Dix-Hallpike or Roll test). A variant of Epley and Barbeque maneuver was used. The Epley maneuver was used for posterior and anterior canal involvement, and "Barbeque roll" was used for horizontal canal involvement. Short-term follow-up was obtained 48 hours and 7 days after initial treatment, whereas long-term follow-up was obtained at repeated 6 month intervals.
  
  
  RESULTS
  The posterior semicircular canal was involved in 521 (88%) patients treated, whereas the horizontal and anterior semicircular canals were involved in 59 (10%) and 12 (2%) patients, respectively. Symptoms subsided immediately in 497 (84%) patients. In 77 (13%) patients, the Dix-Hallpike maneuver remained positive after 48 hours, and CRP was performed again. Patients' mean follow-up was 46 months; 544 (92%) of 592 patients treated reported no symptoms of vertigo.
  
  
  CONCLUSIONS
  Our data, based on long-term follow-up, suggest that CRP remains an efficient and long-lasting noninvasive treatment for BPPV.
authors.affiliation: Department of Otolaryngology, University of Crete School of Medicine, Heraklion, Crete, Greece. epro@med.uoc.gr
authors.forename: Emmanuel P
authors.initials: EP
authors.lastname: Prokopakis
authors.forename: Theognosia
authors.initials: T
authors.lastname: Chimona
authors.forename: Minas
authors.initials: M
authors.lastname: Tsagournisakis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Christodoulou
authors.forename: Barry E
authors.initials: BE
authors.lastname: Hirsch
authors.forename: Vassilios A
authors.initials: VA
authors.lastname: Lachanas
authors.forename: Emmanuel S
authors.initials: ES
authors.lastname: Helidonis
authors.forename: Andreas
authors.initials: A
authors.lastname: Plaitakis
authors.forename: George A
authors.initials: GA
authors.lastname: Velegrakis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture; D012665:Semicircular Canals; D016896:Treatment Outcome; D014717:Vertigo / Q000628:therapy*