Revolutions in Treatment of Posterior Canal Benign Paroxysmal Positional Vertigo

Abstract

Treatment of benign paroxysmal positional vertigo (BPPV) involving the posterior semicircular canal has evolved over the last 25 years from exercises that were thought to jar debris from the cupula of the involved canal and were repeated 20 times, three times a day, to a single manoeuvre that takes only a few minutes to perform. In the course of development of new treatments for BPPV, research has demonstrated the efficacy of the treatment and has also enabled the treatment to be simplified while retaining its benefits. The purpose of this paper is to discuss the canalith repositioning procedure as it was initially described by Epley, as well as to discuss the modifications of the procedure that have been proposed, and to expand on the overall management of the patient with posterior canal BPPV. The results of different studies suggest that, for most patients, CRP can be simplified by omitting pre-medication, mastoid oscillation and the requirement of sitting upright for 48hours The importance of educating the patient before proceeding with testing or treatment is emphasized because it minimizes the patient's distress and helps to assure optimal treatment results.

• canalith repositioning treatment
• Epley
• posterior semi-circular canal