Minimal stimulus strategy for diagnosis and treatment of BPPV: a virtual simulation study.

Abstract

Background: Benign Paroxysmal Positional Vertigo (BPPV) is a common vestibular disorder typically diagnosed and treated through head movements, which can cause discomfort for patients. More importantly, a significant cause of treatment failure is the patient's inability to tolerate these maneuvers.

Objective: To improve patient comfort while maintaining clinical efficacy, this study proposes a Minimal Stimulation Strategy (MSS), utilizing a modified Gufoni maneuver an immediate modified Epley maneuver for BPPV diagnosis and treatment.

Methods: Virtual simulation technology was employed to simulate the trajectory of otolith movement, characteristics of nystagmus, accuracy of localization, and effectiveness of repositioning during the diagnostic and therapeutic processes. This was done to evaluate the scientific validity and effectiveness of MSS in diagnosing and treating BPPV.

Results: The modified Gufoni maneuver effectively identifies BPPV affecting the lateral and posterior semicircular canals. Bilateral application of the Gufoni maneuver enables otolith repositioning in any location within the lateral semicircular canal. The subsequent immediate application of the modified Epley maneuver effectively shortened the otolith repositioning path, reducing treatment time and discomfort.

Conclusion: The proposed MSS not only reduces the stimulation during the diagnostic and therapeutic process but also effectively diagnoses and treats BPPV.