Vibration does not improve results of the canalith repositioning procedure

Objective: To determine whether, in patients with benign paroxysmal positio nal vertigo (BPPV), the canalith repositioning procedure performed with vib ration applied over the mastoid bone of the affected ear is more effective in resolving the symptoms and preventing recurrence of BPPV than the proced ure performed without vibration. Design: Retrospective case review. Setting: Tertiary referral center. Patients: Ninety-four patients diagnosed as having BPPV involving the poste rior semicircular canal. Interventions: Patients were assigned to one of 2 treatment groups: the can alith repositioning procedure with vibration (n=41) and with no vibration ( n=50). Main Outcome Measures: Effectiveness of treatment was determined through cl inical reevaluation or reported through a telephone interview 1 week after treatment. Intensity of symptoms was quantified on a scale of 1 to 3 (mild, moderate, or severe); effectiveness of treatment was categorized on a scal e of 1 to 4 (cure, much better, better, or no change). Rate of recurrence w as determined through later clinical reevaluation or a telephone interview. Results: At 1 week, 57 of the 94 patients were cured and 16 were much bette r, providing a 78% overall success rate. There was no significant differenc e in effectiveness of the treatment or the frequency of reoccurrence of BPP V between the vibration and no-vibration groups as determined from the Kapl an-Meier product-limit method and log-rank rest. Rate of recurrence was 47% at a maximum follow-up of 5.25 years. Conclusions: Our results suggest that, while the canalith repositioning pro cedure is effective in the treatment of BPPV, vibration applied during the maneuver does not significantly affect short-term or long-term outcomes.