Mediterr. J. Otol 2008; 4:(3)

Mastoid Oscillation in the Treatment of the Apogeotropic Variant of Benign Paroxysmal Positional Vertigo of The Lateral Semicircular Canal
Mario Faralli, Fabrizio Longari, GiampietroRicci, Diletta Marinetti, Antonio Frenguelli,
Department of Medical-Surgical Specialization, Otolaryngology and Cervicofacial Surgery Division, University of Perugia, Italy  mario.far@hotmail.it

Objective: The study attempts to verify the effectiveness of mastoid oscillation as a physical measure in addition to repositioning manoeuvres for the treatment of the apogeotropic variant of paroxysmal positional vertigo of the lateral semicircular canal.

Materials and methods: We evaluated 18 patients divided into two groups based on the physical procedures that were used: Group A (9 patients), in which the repositioning manoeuvre alone was used; Group B (9 patients), in which the manoeuvre was preceded by mastoid oscillation (frequency: 100 Hz; amplitude: 0.8 mm) for 60 seconds. The transformation of nystagmus into the geotropic form, expressing migration of the otoliths into the non-ampullary arm, was the main assessment parameter.

Results: Geotropic nystagmus was observed in 22% and 77% of cases, respectively in Group A and Group B, during the first repositioning session, and in 44% and 100%, respectively, after two sessions. The remaining patients from Group A required two more sessions in order to convert nystagmus in all cases. Overall, when compared to Group B (2.22 ±1.86), the patients from Group A presented a statistically significant increase (P=0.014) in the average number of manoeuvres (6.00 ±3.64) in order to convert nystagmus.

Conclusions: Our experience demonstrates that the use of mastoid oscillation in addition to repositioning manoeuvres provides a substantial therapeutic advantage as it shortens the time required to resolve BPPV, thereby reducing the physical and mental stress that vertigo causes in these patients.