Efficacy of Computer-Controlled and Modified Roll Maneuver for Treatment of Geotropic Lateral Canal Benign Paroxysmal Positional Vertigo.

Objective: To evaluate the short-term efficacy of computer-controlled and modified roll maneuver (CMRM) versus conventional roll maneuver (RM) for treatment of geotropic lateral canal benign paroxysmal positional vertigo (BPPV).

Study Design: Prospective case-controlled study.

Setting: Academic hospital.

Patients: One hundred consecutive patients diagnosed as having unilateral idiopathic geotropic lateral canal BPPV with a duration of symptoms of less than 2 weeks.

Interventions: Fifty-two patients (aged 32-80 yr; mean, 55.9 yr; 18 men and 34 women) were treated with CMRM that was composed of three sequential 360-degree rotations and 48 patients (aged 30-71 yr; mean, 52.4 yr; 20 men and 28 women) treated with RM that consisted of one 360-degree rotation.

Main Outcome Measures: Resolution of vertigo on the supine roll test at 48 hours after initial maneuver and the number of maneuvers required for final resolution of vertigo were main outcome measures to assess the efficacy of treatment.

Results: On the supine roll test at 48-hour follow-up after initial maneuver, 44 (84.6%) of 52 CMRM-treated patients and 23 (54.2%) of 48 RM-treated patients had resolution of vertigo (p < 0.01). All patients obtained final resolution of vertigo with a maximum of five maneuvers in each group, but the CMRM group had less mean number of maneuvers required for final resolution of vertigo compared with the RM group (1.23 ± 0.39 versus 1.63 ± 0.68, p < 0.05). No significant adverse effects and complications occurred aside from two patients with conversion into posterior canal BPPV in each treatment.

Conclusion: The CMRM consisting of three sequential 360-degree rotations for geotropic lateral canal BPPV has a higher initial success rate compared with the conventional RM consisting of one 360-degree rotation.