Comparison of outcomes of the Epley and self-Epley maneuvers in PC-BPPV: A randomized controlled trial.

OBJECTIVES

This study aimed to compare the efficacy of the self-Epley and Epley maneuvers in treating posterior canal benign paroxysmal positional vertigo (PC-BPPV) in patients at the outpatient clinic at the Department of Otolaryngology, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.

METHODS

In this prospective, randomized, comparative study, patients with PC-BPPV were randomized to receive the self-Epley or Epley maneuver. The self-Epley maneuver group received illustrated instructions and a video of how to perform the self-Epley maneuver. They then performed the first self-Epley maneuver under supervision in the clinic. The efficacy of the treatment was evaluated with the Dix-Hallpike test at the 1-week follow-up visit.

RESULTS

Sixty-four patients with PC-BPPV were enrolled, 32 patients were the self-Epley maneuver group and the other 32 patients were the Epley maneuver group. After 1 week, 29 of the 32 patients (90.62 %) in the self-Epley maneuver group were cured, while 28 of the 32 patients (87.5 %) in the Epley maneuver group were cured. The Kaplan-Meier survival estimates with a log-rank test for cumulative therapeutic effects at 1 week showed no statistically significant difference between the groups (P = 0.755).

CONCLUSIONS

The twice-a-day self-Epley maneuver had a high success rate and could be used for patients who cannot reach a hospital or needs quarantine due to covid-19. For the self-Epley maneuver, adequate instruction is important to obtain a good result.

LEVEL OF EVIDENCE: II.