540° versus 360° barbecue rotation for HSC-canalithiasis.

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.

Clinical study of horizontal canal benign paroxysmal positional vertigo / 临床神经病学杂志

Objective To study the clinical features and treatment of horizontal canal benign paroxysmal positional vertigo (HC-BPPV).Methods The clinical features of 27 patients with HC-BPPV and the treatment results with otolith repositioning maneuver of Barbecue rotation were analyzed retrospectively.Results All the patients with HC-BPPV had vertigo attack and this kind of vertigo attack presented with some characters such as brief, positioning, latency and no fatigability. Geotropic nystagmus was seen in 21 patients and apogeotropic nystagmus was seen in 6 patients when head was turned to either side in supine position. After Barbecue rotation, all symptoms disappeared in patients with geotropic nystagmus and did not change in patients with apogeotropic nystagmus.Conclusions The diagnosis of HC-BPPV is based on typical clinical features and test of turning head to either side in supine position. Geotropic nystagmus is associated with canalithiasis and apogeotropic nystagmus is associated with cupulolithiasis, and the therapy of Barbecue rotation is very effective to HC-BPPV patients with geotropic nystagmus.

Canalith repositioning maneuver of benign paroxysmal positional vertigo / 临床神经病学杂志

Objective To investigate the therapeutic efficacy of the canalith repositioning maneuver to benign paroxysmal positional vertigo (BPPV). Methods Epley maneuver, Barbecue rotation and Semont maneuver were applied to twelve cases of BPPV. Results Positional vertigo in all subjects disappeared completely 48 hours later by treatment with manipulative reduction, and no obvious adverse reaction was found. There was no recurrence during a follow up from 3 to 11 months.Conclusion The canalith repositioning maneuver is effective, simple and safe for the patients with BPPV and may be recommended as the first-selected treatment modality.