title: An alternative manoeuvre for posterior canal BPPV treatment.
abstract: OBJECTIVE
  The aim of this study is to evaluate the effectiveness of a new manoeuvre in the treatment of posterior canal benign paroxysmal positional vertigo (p-BPPV) based on the idea that highly accelerated endolymphatic flow may lead a mass of otoconia to collide with the walls of the posterior semicircular canal, resulting in its disintegration and/or in the expulsion of the free particles from the posterior semicircular canal.
  
  
  METHODS
  Our study group included 146 patients with a diagnosis of p-BPPV. All patients underwent the new manoeuvre, which consisted of several high-acceleration successive head movements in the horizontal plane performed by the same physician. The results of the study group were compared with those of a sham control group of 30 patients with p-BPPV undergoing placebo treatment. The patients of both groups were reviewed in a follow-up appointment 1 month and 1 year after the initial treatment.
  
  
  RESULTS
  Complete resolution of symptoms immediately after the manoeuvre was observed in 92% of patients. At 1-month and 1-year follow-up assessment, all the patients in the study group reported complete relief from their symptoms compared with only 13% and 43% of control patients respectively. Recurrence of symptoms was reported in 12 patients (8%) from the study group, who responded successfully to one additional session.
  
  
  CONCLUSIONS
  This study establishes the efficacy of the new manoeuvre in the short- and long-term management of p-BPPV. It is a quick office procedure, usually resolving this disorder with a single session, although there some limitations in patients with underlying cervical spine pathology.
authors.affiliation: 1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
authors.forename: V
authors.initials: V
authors.lastname: Vital
authors.forename: G
authors.initials: G
authors.lastname: Psillas
authors.forename: A
authors.initials: A
authors.lastname: Printza
authors.forename: I
authors.initials: I
authors.lastname: Vital
authors.forename: S
authors.initials: S
authors.lastname: Triaridis
authors.forename: I
authors.initials: I
authors.lastname: Konstantinidis
authors.forename: K
authors.initials: K
authors.lastname: Markou
authors.forename: M
authors.initials: M
authors.lastname: Tsalighopoulos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D014717:Vertigo / Q000503:physiopathology / Q000628:therapy*; D055815:Young Adult