Double-blind randomized trial on the efficacy of the Gufoni maneuver for treatment of lateral canal BPPV

Objectives/Hypothesis The need for class I and II studies on the efficacy of liberatory maneuvers in the treatment of lateral canal benign paroxysmal positional vertigo (LC‐BPPV) motivated the present double‐blind randomized trial on the short‐term efficacy of the Gufoni liberatory maneuver (GLM). S...

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Published in:The Laryngoscope 2013-07, Vol.123 (7), p.1782-1786
Main Authors: Mandalà, Marco, Pepponi, Emanuela, Santoro, Giovanni Paolo, Cambi, Jacopo, Casani, Augusto, Faralli, Mario, Giannoni, Beatrice, Gufoni, Mauro, Marcelli, Vincenzo, Trabalzini, Franco, Vannucchi, Paolo, Nuti, Daniele
Format: Article
Language:English
Subjects:
Benign Paroxysmal Positional Vertigo
Clinical trials
Double-Blind Method
double-blind randomized trial
evidence-based
Female
Gufoni liberatory maneuver
Humans
Italy
Male
Middle Aged
Physical Therapy Modalities
semicircular canals
Treatment Outcome
Vertigo - therapy
vestibular
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Summary:Objectives/Hypothesis The need for class I and II studies on the efficacy of liberatory maneuvers in the treatment of lateral canal benign paroxysmal positional vertigo (LC‐BPPV) motivated the present double‐blind randomized trial on the short‐term efficacy of the Gufoni liberatory maneuver (GLM). Study Design Double‐blind randomized controlled trial. Methods Seventy‐two patients with unilateral LC‐BPPV were recruited for a multicentric study. Patients were randomly assigned to treatment by GLM (n = 37) or sham treatment (n = 35). Subjects were followed up twice (at 1 hour and 24 hours) with the supine roll test by blinded examiners. Results At 1‐ and 24‐hour follow‐up, 75.7% and 83.8% of patients, respectively, undergoing GLM had recovered from vertigo, compared to around 10% of patients undergoing the sham maneuver (P < 0.0001). Conclusion To the best of our knowledge, this is the first class I study on the efficacy of the GLM in the treatment of LC‐BPPV in both geotropic and apogeotropic forms. GLM proved highly effective compared to the sham maneuver (P < 0.0001). The present class I study of the efficacy of the GLM changes the level of recommendation of the method for treating LC‐BPPV from level U to level B for the geotropic variant and from level B to level A for the apogeotropic variant of LC‐BPPV. Level of Evidence 1b. Laryngoscope, 2013
ISSN:0023-852X
1531-4995
DOI:10.1002/lary.23918