Mediterr. J. Otol 2006; 3:103-111

Diagnosis and management of lateral canal benign paroxysmal positional vertigo

Essam Ali Saleh 

Department of Otolaryngology, Faculty of Medicine, Alexandria University, Alexandria, Egypt    salehessam@yahoo.com

OBJECTIVE: To present our experience in the treatment of lateral semicircular canal benign paroxysmal positional vertigo by using a 360° barbecue rotation followed by placing the patient in a forced prolonged position.

PATIENTS AND METHODS: This study consisted of 34 patients with lateral canal benign paroxysmal positional vertigo. Twenty of those subjects exhibited the geotropic variant, and 14 had apogeotropic nystagmus. The geotropic form was treated with a 360° barbecue rotation toward the healthy side followed by the patient’s lying in a forced prolonged position on the healthy side. Attempts at canal conversion from the apogeotropic form to the geotropic form were made by subjecting the patient to head shaking, a 180° roll or barbecue rotation toward the healthy side, and lying in a forced prolonged position on the diseased side.

RESULTS: Of the 20 patients with the geotropic variant, 17 (85%) were cured and 3 (15%) improved. Of those with the apogeotropic variant, 11 patients (87.6%) were cured, 1 (7.1%) improved, and 2 (14.3%) experienced no benefit from treatment. The overall result was improvement or cure in 32 of 34 patients (94.1%). Many patients underwent more than 1 therapeutic maneuver to achieve those results.

CONCLUSION: Lateral canal vertigo is more difficult to treat than posterior canal positional vertigo. The apogeotropic variant is usually more difficult to treat than the geotropic type, and canal conversion should be tried before treatment is initiated.