Abstract
Objective: A simplified and shorter version of the Epley maneuver for successful canalith repositioning and deposition from the posterior semicircular canal (SCC) into the utricle of the vestibular labyrinth in the treatment of benign paroxysmal positional vertigo (BPPV) as confirmed by a positive Dix-Hallpike test is described.
Method: Adjustable head-set positioned patients providing 3D representation of vestibular apparatus. Three latex free tubes positioned at 90-degree angles to one another representing SCC arrangement in both ears. Communication via hollow plastic-cavity representing the utricle. Mobile metal ball bearing representing the canalith placed into the lumen posterior SCC tube of the affected ear determined following positive Dix-Hallpike test.
Results: As described by Epley, the head is placed over the end of the table and turned 45 degrees to the affected ear so the canalith gravitates to the center of the posterior SCC. While the head is tilted below the horizontal it is rotated 45 degrees toward the other ear so the canalith reaches the common crus. At this stage the patient is then turned prone, looking directly at the floor, and subsequently the canalith enters the utricle. This method has 85% success rate in BPPV patients with a positive Dix-Hallpike test.
Conclusion: The method incorporates fewer steps than the Epley maneuver and is less time consuming in busy otolaryngology clinics achieving the desired outcome, with the advantage of educating patients and junior doctors about canalith movement through SCCs with head-set resembling valuable visual aid-memoire. The senior author successfully used this technique for 10 years for short term resolution of BPPV-associated symptoms.
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