The 360-degree maneuver for treatment of benign positional vertigo.
OBJECTIVE: The purpose of this study was to determine whether rotating a patient 360 degrees in the plane of the posterior semicircular canal is effective in treating classic benign paroxysmal positional vertigo. The study also compares the features of the Epley maneuver and the Semont maneuver and correlates them to the 360-degree maneuver. STUDY DESIGN: A prospective analysis of 31 patients presenting with benign paroxysmal positional vertigo who were treated using the multiaxial positioning device. A questionnaire was administered immediately after each treatment. SETTING: The study was carried out in a private practice referral clinic for benign paroxysmal positional vertigo. PATIENTS: Subjects consisted of 31 adults who ranged in age from 44 to 95 years. INTERVENTION: Thirty-one patients were treated using the 360-degree maneuver. A multiaxial positioning device was used to rotate patients completely upside down and back into the starting position in the proper plane. MAIN OUTCOME MEASURES: Subjective improvement scores, tolerability, objective nystagmus observations, and complications were recorded. RESULTS: Subjective improvement rates were 90% after one treatment; 97% were symptom-free and nystagmus-free after a maximum of three treatment sessions. Eighty-seven percent found the procedure quite tolerable from an ergonomic standpoint. CONCLUSION: The 360-degree maneuver can be effective in treating benign paroxysmal positional vertigo. Its rate of success is comparable to the rate of success of the standard Epley maneuver. On analysis, it is strikingly similar to the Epley and Semont maneuvers.