Modified Canalith Repositioning Procedure for Benign Paroxysmal Positional Vertigo.

The majority of benign paroxysmal positional vertigo (BPPV) cases with posterior canal lesion can be easily cured by the canalith repositioning procedure (CRP). BPPV with lateral canal lesions can also be cured by a modified CRP specifically designed by the authors. There are some cases which present with a combination of pure-torsional nystagmus and direction-changing geotropic nystagmus. This type of BPPV could involve both posterior and lateral semicircular canals. Twelve cases of such a combined type of BPPV were treated by applying the CRP for each canal. Complete remission was obtained in 5 cases, and a substantial decrease in the nystagmus was observed in the other 7 cases. The CRP should be applied to cases of BPPV with combined lesions as the first choice of treatment.