540° versus 360° barbecue rotation for HSC-canalithiasis

Abstract

BACKGROUND:

There are some variations of barbecue rotation to treat canalithiasis of horizontal semicircular canal (HSC-canalithiasis). But a 540° approach has never been reported.

OBJECTIVE:

To compare a modified 540° to a traditional 360° barbecue rotation for treatment of HSC-canalithiasis.

METHODS:

Sixty consecutive patients with HSC-canalithiasis were prospectively allocated to two groups of log roll treatment, either 540° or 360° barbecue rotation (Br540 or Br360). Only one application was allowed in each visit, with weekly repetitions until the resolution of positional nystagmus and vertigo.

RESULTS:

In each group, 2 patients were lost to follow-up so that 28 were analyzed. With “multi-canal sufferers” or “canal switchers” included, 25, 2, and 1 patients in the Br540 needed 1, 2 and 4 canalith repositioning procedures (CRP) respectively to cure the HSC-canalithiasis, while 17, 6, 5 in the Br360 required 1, 2 and 3 CRPs (p = 0.011). With “multiple canal sufferers” and “canal switchers” excluded from analysis, 19, 1, and 1 patients in the Br540 needed 1, 2 and 4 CRPs respectively, while 16, 6, 4 in the Br360 required 1, 2 and 3 CRPs (p = 0.027). The success rate with one application was higher in the 540° group than the 360° group, about 90% versus 61% (P < 0.05 in both analyses).

CONCLUSION:

A 540° barbecue rotation is probably superior to 360° for treatment of HSC-canalithiasis.