Comparing therapeutic maneuvers in posterior canal benign paroxysmal positional vertigo

Abstract

Context: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo accounting for around 24% of all peripheral vestibular abnormalities and the posterior semicircular canal being the most affected. The most common cause of BPPV is idiopathic, others being inner ear disorders, trauma, infection, and increasing age. Objective: This study evaluated the efficacy of Epley's maneuver alone and Epley's maneuver with Brandt–Daroff exercises in the management of posterior semicircular canal BPPV, thereby comparing the recurrence rate after treatment in both groups. Materials and Methods: The study was a randomized prospective clinical trial with parallel and superiority trial design where 94 consecutive patients with posterior semicircular canal BPPV and fulfilling the inclusion criteria were enrolled into two Groups A = 47 and B = 47. All subjects underwent detailed history, examination, and assessment with UCLA dizziness questionnaire and videonystagmography. Group A patients received Epley's maneuver while group B received Epley's maneuver with Brandt–Daroff exercises as the treatment, with follow-up done on the 1st and 2nd weeks and after 1 month. Results: The age group of the majority of the patients in the study ranged between 51 and 60 years. The percentage of females in the study was 54.3% and males 45.7%. Results showed significant improvement in vertigo and nystagmus in both groups, with Group B having lesser recurrence during the follow-up visits. Conclusion: Both Epley's maneuver and Brandt–Daroff exercises are ideal means of treatment, but a combined approach of the two maneuvers yields better outcome in terms of symptomatic resolution and less recurrence.