Success of the modified Epley maneuver in treating benign paroxysmal positional vertigo

Objective: Benign paroxysmal positional vertigo (BPPV) is a common conditio n seen by otolaryngologists. The purpose of this study is to determine the ability of the modified Epley maneuver to treat BPPV, Study Design: Retrosp ective review. Methods: A retrospective chart review of 107 patients diagno sed with BPPV at our institution between March of 1993 and June of 1995, Ea ch patient was diagnosed with isolated BPPV by history and Hallpike-Dix man euver. There were no other vestibular symptoms or electronystagmogram abnor malities. Patients diagnosed with BPPV received modified Epley maneuvers, w ere instructed to remain upright for 48 hours, and wore a soft collar for a week. Patients were followed up with repeat Hallpike-Dix maneuvers at 1 to 2 weeks. If symptoms persisted, the maneuver was repeated for up to a maxi mum of three times, at which point patients were considered to have failed treatment. Results: The average age of patients was 57.8 years old. Thirty percent were male and the right ear was affected in 54%. The posterior semi circular canal was affected in 105 ears, The average patient received 1.23 Epley maneuvers, with a success rate of 93.4%. No successfully treated pati ents received mastoid vibration, Seven out of 107 patients failed after thr ee Epley maneuvers. Two failure patients had a history of temporal bone fra cture. Two failure patients were treated with posterior semicircular canal block surgery. Conclusion: The modified Epley maneuver is an excellent trea tment for BPPV.