Premium
Double‐Blind Randomized Trial on the Efficacy of the Forced Prolonged Position for Treatment of Lateral Canal Benign Paroxysmal Positional Vertigo
Author(s) -
Mandalà Marco,
Califano Luigi,
Casani Augusto Pietro,
Faralli Mario,
Marcelli Vincenzo,
Neri Giampiero,
Pecci Rudi,
Scasso Felice,
Scotto di Santillo Leonardo,
Vannucchi Paolo,
Giani Beatrice,
Dasgupta Soumit,
Bindi Ilaria,
Salerni Lorenzo,
Nuti Daniele
Publication year - 2021
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.28981
Subject(s) - medicine , benign paroxysmal positional vertigo , supine position , vertigo , randomized controlled trial , double blind , surgery , clinical trial , anesthesia , clinical efficacy , placebo , alternative medicine , pathology
Objectives/Hypothesis The need for class I and II studies on the efficacy of liberatory maneuvers in the treatment of lateral canal benign paroxysmal positional vertigo (LC‐BPPV) motivated the present double‐blind randomized trial on the short‐term efficacy of the forced prolonged position (FPP). Study Design Double‐blind, randomized controlled trial. Methods Two hundred twenty‐one patients with unilateral LC‐BPPV met the inclusion criteria for a multicentric study. Patients were randomly assigned to treatment by FPP (116 subjects) or sham treatment (105 subjects). Subjects were followed up at 24 hours with the supine roll test by blinded examiners. Results Among the sample, 67.4% and 32.6% of the patients showed respectively geotropic and apogeotropic variant of LC‐BPPV. At the 24‐hour follow‐up, the effectiveness of FFP compared to the sham maneuver was, respectively, 57.8% versus 12.4% ( P < .0001) in the total sample, 76.9% versus 11.3% ( P < .0001) in the geotropic variant group, and 60.5% versus 17.6% ( P = .0003) in the apogeotropic variant group, including resolution or transformation to geotropic variant. Conclusions FPP proved highly effective compared to the sham maneuver. The present class 2 study of the efficacy of the FPP changes the level of recommendation of the method for treating LC‐BPPV into a strong one. Level of Evidence 2 Laryngoscope , 131:E1296–E1300, 2021