A Liberatory Maneuver for the Treatment of Horizontal Canal Paroxysmal Positional Vertigo

Appiani, Giuseppe Ciniglio; Catania, G; Gagliardi, Mario

doi:10.1097/00129492-200101000-00013

Cited by 70 publications

(37 citation statements)

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“…Some years ago, Gufoni et al [1998] described a method of treatment that involves shifting the patient rapidly from a sitting position to the healthy side (in the geotropic forms) or to the affected side (in the apogeotropic forms). Studies performed with this new therapeutic approach report 93-100% success in geotropic forms [Appiani et al, 2001;Vannucchi et al, 2005;Riggio et al, 2009]. However, when this maneuver was used for apogeotropic forms of HSC-BPPV, the results were not as good: the success rate was never more than 70% Vannucchi et al, 2005], confirming that this type of HSC-BPPV is more difficult to solve because of the debris being situated where its elimination is certainly a more complex matter.…”

Section: Color Version Available Onlinementioning

confidence: 99%

Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo: Effectiveness of Two Different Methods of Treatment

Casani¹,

Nacci

Dallan³

et al. 2010

Audiol Neurotol

106

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The aim of this study is to compare the results obtained using 2 methods of treatment for horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV): the barbecue maneuver + forced prolonged position (FPP) versus the Gufoni maneuver. In a randomized prospective clinical trial, we recruited 147 patients affected by HSC-BPPV. The primary outcome was the absence of vertigo and nystagmus upon application of the supine roll test during the follow-up examination. A statistical evaluation was performed in order to assess whether any parameters (e.g. age, duration of nystagmus and symptoms) could influence in any way the results obtained with the 2 methods of treatment. One hundred and three of the 147 patients affected by HSC-BPPV had the geotropic form and 44 had the apogeotropic type. We were able to transform 29 cases of HSC-BPPV from apogeotropic to geotropic. Finally, we obtained a group of 112 patients who were randomized either to the barbecue + FPP procedure (54 patients) or to the Gufoni maneuver (58 patients). The most evident result is the higher percentage of success (statistically significant) with the Gufoni maneuver at the first session of treatment (86 vs. 61%). The final control showed that 44 out of 54 (81%) patients treated with the barbecue maneuver + FPP were symptom free compared to 54 out of 58 (93%) treated with the Gufoni maneuver. Both the barbecue maneuver + FPP and the Gufoni maneuver are valid methods for treating HSC-BPPV (geotropic forms). However, our results also indicate that the Gufoni maneuver has a significant advantage: the success rate shown at the follow-up, although without statistical significance, is undoubtedly higher (93 vs. 81%). This result, together with the fact that it is very easy to perform and that patient compliance is better, make the Gufoni maneuver the method of choice in HSC-BPPV treatment.

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Section: Color Version Available Onlinementioning

confidence: 99%

Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo: Effectiveness of Two Different Methods of Treatment

Casani¹,

Nacci

Dallan³

et al. 2010

Audiol Neurotol

106

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“…Essa resposta nistág-mica costuma ter uma latência muito curta de poucos segundos, tem característica paroxística, costuma durar menos que um minuto, não é fatigável com a repetição da manobra e produz um nistagmo puramente horizontal (geotrópico ou ageotrópico) que muda de direção com o giro da cabeça para o lado oposto e que tem maior intensidade para um dos lados. 8 O mais comum é uma resposta nistágmica geotrópi-ca (em direção ao ouvido na posição mais inferior) para ambos os lados (Vídeo 3 D). Isso indica uma canalitíase do canal lateral, ou seja, os debris otoconiais estão posicionados no braço longo do canal semicircular lateral.…”

Section: Manobra De DIX E Hallpikeunclassified

“…9 Manobras de reposicionamento nas quais o paciente é instruído a mover-se da posição sentada para a posição de queda lateral (Manobra de Gufoni) tem a vantagem de consumir menos tempo de execução e ser mais confortável para o paciente. 9 Gufoni em 1998 introduziu uma nova manobra liberadora que é também conhecida como manobra de Asprella-Gufoni 9 e consiste das seguintes etapas quando estamos diante da variante geotrópica da VPPB de canal lateral 8 (http://borgesdecarvalhootorrinos.com. br/wp-content/uploads/2014/04/Video-3T.mp4?_=8).…”

Section: Manobras De Tratamento Para Vppb De Canal Lateralunclassified

“…8 Usando tanto a força gravitacional, quanto a aceleração angular enquanto o paciente executa movimentos com facilidade, torna-se a manobra de Asprella-Gufoni uma primeira opção válida e efetiva no tratamento da VPPB de canal lateral. 9 Na variante ageotrópica da VPPB de canal lateral os otólitos estão localizados no segmento mais anterior do canal.…”

Section: Manobras De Tratamento Para Vppb De Canal Lateralunclassified

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Desvendando as manobras otoneurológicas

Carvalho¹

2015

Revista Hospital Universitário Pedro Ernesto

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31Resumo A vertigem postural paroxística benigna (VPPB) é provavelmente o diagnóstico mais comum em setores de otoneurologia de clínicas e hospitais. Embora, na maioria das vezes, tenha um bom prognóstico evolutivo, alguns casos podem durar semanas ou meses, gerando insegurança, risco de quedas e prejuízos laborativo e social. O desenvolvimento do tratamento da VPPB por meio de manobras de reposicionamento e liberação das partículas otoconiais encurtou o prazo de sua resolução, sendo esse enfoque terapêutico tratado aqui nesta revisão. Ao longo dos anos, diversos autores desenvolveram e aperfeiçoa-ram técnicas de manobras, com o objetivo de ampliar as opções terapêuticas nos diferentes tipos de apresentação clínica da VPPB. Vamos enfatizar nessa revisão as manobras de uso mais atual, ao mesmo tempo em que comentaremos essas diferentes apresentações clínicas. A literatura recente confirma a eficácia dessa modalidade de tratamento da VPPB, e o conhecimento de suas nuances é importante para um resultado satisfatório.Descritores: Vertigem; Nistagmo patológico; Terapêutica. Abstract Unmasking maneuvers in neurotologyBenign paroxysmal positional vertigo (BPPV) is probably the most common diagnostic found in hospitals and clinics which are specialized in the neurotology field. Although most of the times a good evolutive prognostic is reached, some cases could last for weeks or even months, generating insecurity, risk of falls as well as labor and social prejudice. The development of the treatment through repositioning maneuvers and the release of otoconia particles has shortened the length of its resolution, and this therapeutic approach is being discussed in this review. Over the years, several authors have developed and improved maneuvers techniques, with the objective of amplifying the therapeutic options spectrum on different types of clinical BPPV presentation. During this review, the most updated maneuvers will be emphasized as well as different clinical presentations. The most recent literature confirms the efficiency of this type of BPPV treatment, and the knowledge of its nuances is the key to a successful result.Keywords: Vertigo; Nystagmus, pathologic;Therapeutics. Desvendando as manobras otoneurológicas Resumen Descubriendo las maniobras otoneurológicasEl vértigo postural paroxístico benigno (VPPB) es, probablemente, el diagnóstico más común en sectores de Otoneurología de clínicas y hospitales. Aunque la mayoría de veces, tiene un buen pronóstico evolutivo, algunos casos pueden durar semanas o meses, generando: inseguridad, riesgo de caídas y prejuicios laborales y sociales. El desarrollo del tratamiento del VPPB por medio de maniobras de reposicionamiento y liberación de partículas otoconiales acorta el tiempo de su resolución, éste enfoque terapéutico es tratado en esta revisión. Con el paso del tiempo, diversos autores desarrollaron y perfeccionaron técnicas de maniobra, con el objetico de ampliar las opciones terapéuticas en los diferentes tipos de presentación clínica del VPPB. Destacamos en esta rev...

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“…Of course, BPPV affecting the horizontal semicircular canals would be provoked using these types of positions [8,9]. Placing a patient with spontaneous nystagmus resulting from an acute unilateral labyrinthine involvement into various positions may also alter the nystagmus.…”

Section: Introductionmentioning

confidence: 99%

Positional Nystagmus in Patients Evaluated for Dizziness and Imbalance

Roberts¹,

Bittel

Gans

2016

Advances in Otolaryngology

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There is variability in the literature regarding the presence of positional nystagmus in healthy participants with reportedly normal vestibular and central nervous system function. This ranges from 7.5% to 88% and raises an important clinical question. If 88% of healthy participants have positional nystagmus then how is the clinician to interpret the presence of positional nystagmus in a patient presenting with dizziness and/or disequilibrium? The primary purpose of this investigation was to examine the prevalence and characteristics of positional nystagmus in patients evaluated specifically for dizziness and imbalance. Data was collected using retrospective chart review. 200 charts were randomly selected from all patients seen for evaluation of dizziness and imbalance over a period of eight months. Clinicians independently reviewed the data from positional testing for each chart. Nystagmus was present if there was a clear slow and fast phase component and there were three beats in a 10 s time window. Nystagmus direction and intensity data were collected. Results indicate positional nystagmus is present in 10.5% to 21% of patients evaluated for dizziness and imbalance. Use of liberal criteria for determining presence of positional nystagmus (i.e., 3 beats in 20 sec) may account for higher prevalence rates across other studies.

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A Liberatory Maneuver for the Treatment of Horizontal Canal Paroxysmal Positional Vertigo

Abstract: This approach represents a simple and effective approach to the management of the geotropic form of HC-PPV.

Cited by 70 publications

References 7 publications

Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo: Effectiveness of Two Different Methods of Treatment

Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo: Effectiveness of Two Different Methods of Treatment

Desvendando as manobras otoneurológicas

Positional Nystagmus in Patients Evaluated for Dizziness and Imbalance

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