Interventions for apogeotropic horizontal canal benign paroxysmal positional vertigo: a systematic review

Abstract Background A 2021 systematic review reported that all of the included maneuvers for the treatment of geotropic horizontal canal benign paroxysmal positional vertigo (BPPV) demonstrated high efficacy and few contraindications. However, a similar systematic review for the apogeotropic subtype of horizontal canal BPPV has not been published. Objectives The purpose of this systematic review was to evaluate the effectiveness of current treatment options for apogeotropic horizontal canal BPPV. Methods The databases accessed from inception through 2021 were CINAHL Complete, PubMed, and Web of Science. The search terms utilized were (ageotropic OR apogeotropic) AND (horizontal OR lateral) AND vertigo. A 10-item tool developed by Medlicott and Harris was utilized to assess methodological rigor. Results Three of the included maneuvers (the Gufoni maneuver, the Zuma maneuver, and the Cupulolith Repositioning maneuver) demonstrated 100% efficacy after only one treatment session. The Gufoni maneuver may be preferable for individuals who are elderly, obese, or have problems with their general mobility because it does not require the individual to perform a roll. Although the Zuma maneuver is also easy to perform on these types of individuals, only one study has been completed on this maneuver. Because the Cupulolith Repositioning maneuver is a roll maneuver, it may not be tolerated by all individuals. Conclusions The Gufoni maneuver may be the best maneuver to initially consider because it has been more well-studied than the Zuma maneuver; and it may be more comfortable than the Cupulolith Repositioning maneuver for certain types of individuals.