Large Variability of Head Angulation During the Epley Maneuver: Use of a Head-Mounted Guidance System with Visual Feedback to Improve Outcomes

Rajneesh Bhandari*, Anita Bhandari*, Herman Kingma, Raymond van de Berg

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: The aim of this study was to show the variability in head angulation during the canalolith repositioning maneuvers to treat benign paroxysmal positional vertigo and to describe a head-mounted benign paroxysmal positional vertigo guidance system to measure the head orientation. METHODS: A guidance system for benign paroxysmal positional vertigo was developed by NeuroEquilibrium Diagnostic Systems to measure head orientation and provide visual feedback and instructions to examiners during various maneuvers for benign paroxysmal positional vertigo. Twenty-five experienced examiners and 25 healthy volunteers (aged 21-35 years) were recruited. Each examiner applied the Epley maneuver twice in 1 volunteer: without and with the use visual feedback from a guidance system. Head orientation in both procedures was measured and compared. RESULTS: The trained examiners demonstrated a large variability in head orientation during the Epley maneuver, which was reduced by using the benign paroxysmal positional vertigo guidance system. There was a variability of 39-65° in head orientation measured without the guidance system. The use of the guidance system reduced the variation range to a sixfold decrease in variability. CONCLUSION: There is a large variability in head orientation when performing repositioning maneuvers, which could compromise the efficacy of benign paroxysmal positional vertigo treatment. Treatment for benign paroxysmal positional vertigo can be optimized by reducing this variability with a benign paroxysmal positional vertigo guidance system. It might also be a useful tool for teaching.
Original languageEnglish
Pages (from-to)234-241
Number of pages8
JournalJournal of International Advanced Otology
Volume19
Issue number3
DOIs
Publication statusPublished - 1 May 2023

Keywords

  • BPPV
  • Epley maneuver
  • guidance system
  • head angulation

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