How is BPPV treated when lateral canal involvement is suspected?

How is BPPV treated when lateral canal involvement is suspected?

• A. Lempert maneuver
• B. Epley maneuver
• C. Deep head hanging maneuver
• D. Brandt-Daroff exercises

Answer: (A)

When the horizontal (lateral) canal is affected, the goal is to move debris through that canal back to the utricle. The Lempert maneuver, or barbecue roll, accomplishes this with a full 360-degree series of side-to-side rolls to reposition the canaliths in the horizontal canal. The Epley maneuver targets the posterior canal, so it isn’t appropriate for lateral canal BPPV. The deep head-hanging maneuver is used for anterior (vertical) canal involvement, not the lateral canal. Brandt-Daroff exercises are home habituation exercises and are less effective as primary therapy for lateral canal BPPV, though they can be used if professional maneuvers aren’t feasible.

When the horizontal (lateral) canal is affected, the goal is to move debris through that canal back to the utricle. The Lempert maneuver, or barbecue roll, accomplishes this with a full 360-degree series of side-to-side rolls to reposition the canaliths in the horizontal canal. The Epley maneuver targets the posterior canal, so it isn’t appropriate for lateral canal BPPV. The deep head-hanging maneuver is used for anterior (vertical) canal involvement, not the lateral canal. Brandt-Daroff exercises are home habituation exercises and are less effective as primary therapy for lateral canal BPPV, though they can be used if professional maneuvers aren’t feasible.