To develop simple and effective methods for determining the affected side and promoting early symptom resolution in lateral semicircular canal-benign paroxysmal positional vertigo (L-BPPV) due to canalolithiasis, including its geotropic (L-BPPV-can-geo) and apogeotropic (L-BPPV-can-apo) variants.
Clinicians managing lateral canal BPPV canalolithiasis should review this study's proposed maneuvers as potential simple alternatives for side identification and repositioning, but await independent replication before replacing established protocols such as the Gufoni or BBQ roll maneuver.
Lateral semicircular canal BPPV is commonly misdiagnosed or under-treated due to difficulty identifying the affected side; simpler, reliable maneuvers could meaningfully improve first-visit resolution rates in vestibular clinics.
- 01Two new maneuvers proposed: healthy-ear-down 135° and affected-ear-down 135°.
- 02Targets lateral semicircular canal BPPV canalolithiasis, a frequent but tricky BPPV subtype.
- 03First maneuver aids affected-side identification; second performs otolith repositioning.
- 04Published in Auris Nasus Larynx (2026); PMID 42119172.
- 05Method is described as 'simple,' potentially lowering the procedural skill threshold.
The healthy-ear-down 135° maneuver can reliably identify the affected side in lateral canal BPPV canalolithiasis.
studypartially supportedThe affected-ear-down 135° maneuver successfully repositions displaced otoliths in lateral canal BPPV canalolithiasis.
studypartially supportedThese maneuvers are simpler to perform than existing lateral canal BPPV repositioning procedures.
opinionunclear- PMID
- 42119172
- DOI
- 10.1016/j.anl.2026.04.013.
- Journal
- Auris Nasus Larynx
- Publication type
- research_article
- Evidence level
- 4
- Population
- Patients with lateral semicircular canal BPPV canalolithiasis
- Intervention
- Healthy-ear-down 135° maneuver and affected-ear-down 135° maneuver
Primary outcomes
Accuracy of affected-side identification; Resolution of BPPV symptoms following repositioning maneuver