Mastoid oscillation in canalith repositioning for paroxysmal positional vertigo

Objective: The canalith repositioning procedure (CRP) was developed to trea t paroxysmal positional vertigo (PPV). Successful CRP results in cessation of PPV and positional nystagmus. Mastoid oscillation (MO) has been advocate d to enhance the efficacy of CRP. The authors sought to objectively determi ne the effect of MO on CRP. Study Design: Retrospective review. Setting: Ambulatory referral center. Patients: Patients with PPV seen from 1993 through 1999 (N = 168). Interventions: Canalith repositioning procedure performed without MO (n = 1 04 and performed with MO (n = 64). Main Outcome Measure: Presence or absence of nystagmus on Dix-Hallpike test ing 6 weeks after CRP. Results: Eighty-four percent of patients treated with MO had resolution, an d 16% had persistent nystagmus. Seventy-three percent of patients without M O had resolution, and 27% had persistent nystagmus. Although suggesting a t rend, the difference did not reach the level of significance (p = 0.151). Conclusions: Mastoid oscillation does not significantly enhance the efficac y of the CRP.