Single Cycle Versus Multiple Cycles of Canalith Repositioning Procedure for Treatment of Posterior Canal Benign Paroxysmal Positional Vertigo: A Randomized Controlled Trial

Abstract

OBJECTIVE: To compare the treatment outcomes and complications of single cycle versus multiple cycles of the canalith repositioning procedure (CRP). STUDY DESIGN: Randomized controlled trial. SETTING: Academic tertiary referral center; Chiang Mai University, Thailand. PATIENTS: One hundred and forty-three adults who had unilateral posterior canal benign paroxysmal positional vertigo (BPPV). INTERVENTION: Therapeutic. Patients received either a single cycle or multiple cycles of the CRP in one session. MAIN OUTCOME MEASURES: Rate of negative Dix-Hallpike test (DHT), rate of symptom improvement, dizziness handicap inventory score (DHI), and rate of complications. RESULTS: At the 1st week and the 4th week recall visits after CRP the treatment outcomes between the single-CRP group and the multiple-CRP group showed no significant difference. The outcomes included: 1) rate of negative DHT (1st week: 76.9 and 76.7%, 4th week: 89.5 and 88.2%); 2) rate of complete recovery or improved symptoms (1st week: 92.3 and 91.7%; 4th week: 96.5 and 98.0%); 3) DHI scores (1st week: 22 and 28; 4th week: 6 and 10); and 4) complication rate (1st week: 12.5 and 20%; 4th week: 20 and 0%. Rate of complications in the single-CRP group (6.9%) during the 1st treatment was lower than in the multiple-CRP groups (21.1%) (p-value = 0.013). CONCLUSION: A single cycle of CRP is as effective as multiple cycle CRP, with a lower incidence of complication and a decrease in the time for treatment. Single-cycle CRP is a more advantageous treatment for unilateral posterior canal BPPV. CLINICALTRIALS. GOV IDENTIFIER: NCT02701218.