Head-Shaking vs. Mastoid Oscillation for PC-BPPV-cu
Trial question
What is the effect of head-shaking versus mastoid oscillation maneuver in patients with cupulolithiasis of posterior canal benign paroxysmal positional vertigo?
Study design
Multi-center
Double blinded
RCT
Population
Characteristics of study participants
70.0% female
30.0% male
N = 106
106 patients (74 female, 32 male).
Inclusion criteria: patients with cupulolithiasis of posterior canal benign paroxysmal positional vertigo.
Key exclusion criteria: age < 20 years; multicanal benign paroxysmal positional vertigo; cervical spine problems; cognitive dysfunction.
Interventions
N=53 head-shaking maneuver (after pitching the head forward by 30°, the head was moved laterally at a sinusoidal rate of approximately 3 Hz for 15 seconds while seated).
N=53 mastoid oscillation maneuver (mastoid oscillation was applied to the lesion-side mastoid area using a 100 Hz handheld vibrator for 30 seconds while seated).
Primary outcome
Rate of short-term resolution rate of positional vertigo and nystagmus the following day
37.7%
26.4%
37.7 %
28.3 %
18.9 %
9.4 %
0.0 %
Head-shaking
maneuver
Mastoid oscillation
maneuver
No significant
difference ↔
No significant difference in the rate of short-term resolution rate of positional vertigo and nystagmus the following day (37.7% vs. 26.4%; AD 11.3%, 95% CI -6.3 to 28.9).
Safety outcomes
No significant difference in adverse events.
Conclusion
In patients with cupulolithiasis of posterior canal benign paroxysmal positional vertigo, head-shaking maneuver was not superior to mastoid oscillation maneuver with respect to the rate of short-term resolution rate of positional vertigo and nystagmus the following day.
Reference
Eun Hye Oh, Jae-Hwan Choi, Hyun Sung Kim et al. Treatment Maneuvers in Cupulolithiasis of the Posterior Canal Benign Paroxysmal Positional Vertigo: A Randomized Clinical Trial. JAMA Netw Open. 2025 Mar 3;8(3):e250972.
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