Affiliations: [a] Interdisciplinary Program in Bioengineering, Graduate School, Seoul National University, Seoul, Korea
| [b] Department of Biomedical Engineering, College of Medicine, Chungnam National University, Daejeon, Korea
| [c] Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea
| [d] Institute of Medical & Biological Engineering, Medical Research Center, Seoul National University, Seoul, Korea
| [e] Department of Biomedical Engineering, College of Medicine, Seoul National University, Seoul, Korea
| [f] Transdisciplinary Department of Medicine & Advanced Technology (TDMAT), Seoul National University Hospital, Seoul, Korea
Correspondence:
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Corresponding author: Myung-Whan Suh, MD, PhD, Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital Yongon-Dong, Chongno-Gu, Seoul 110–744, Republic of Korea. Tel.: +82 2 2072 3649; Fax: +82 2 745 2387; E-mail: drmung@naver.com.
Note: [1] Chiheon Kwon and Yunseo Ku contributed equally as co-first authors.
Abstract: BACKGROUND:Low success and high recurrence of benign paroxysmal positional vertigo (BPPV) after home-based self-treated Epley and Barbeque (BBQ) roll maneuvers is an important issue. OBJECTIVE:To quantify the cause of low success rate of self-treated Epley and BBQ roll maneuvers and provide a clinically acceptable criterion to guide self-treatment head rotations. METHODS:Twenty-five participants without active BPPV wore a custom head-mount rotation monitoring device for objective measurements. Self-treatment and specialist-assisted maneuvers were compared for head rotation accuracy. Absolute differences between the head rotation evaluation criteria (American Academy of Otolaryngology guidelines) and measured rotation angles were considered as errors. Self-treatment and specialist-treated errors in maneuvers were compared. Between-trial variations and age effects were evaluated. RESULTS:A significantly large error and between-trial variation occurred in step 4 of the self-treated Epley maneuver, with a considerable error in the second trial. The cumulative error of all steps of self-treated BBQ roll maneuver was significantly large. Age effect occurred only in the self-treated BBQ roll maneuver. Errors in specialist-treated maneuvers ranged from 10 to 20 degrees. CONCLUSIONS:Real-time feedback of head movements during simultaneous head-body rotations could increase success rates of self-treatments. Specialist-treated maneuvers can be used as permissible rotation margin criteria.
Keywords: BPPV, dizziness, head motion tracking, Epley maneuver, Barbeque roll
maneuver
