Home particle repositioning maneuver to prevent the recurrence of posterior canal BPPV Elshahat Ibrahem Ismail *, Ashraf Elsayed Morgan, Mohamed Moustafa Abdeltawwab Faculty of Medicine, Mansoura University, Egypt 1. Introduction Benign paroxysmal positional vertigo (BPPV) is known to be the commonest cause of vertigo. It represents 1% of patients evaluated by neurologists and ear, nose, and throat specialists [1,2]. The most common type of BPPV is posterior canal BPPV (pc-BPPV), which has a lifetime prevalence of 2.4% [2]. Posterior canal BPPV (pc-BPPV) represents 80–90% of BPPV, while lateral-canal BPPV (LC-BPPV) is reported in 10– 20% of patients [3]. However, most recent investigations stated that the horizontal–canal variant has been underestimated with an occurrence frequency of 10–30% [4,5]. A specific type of BPPV is pc-BPPV. It can be cured by the Epley maneuver and it represents the most affected canal (90.2%) [6,7]. Diagnosis of pc-BPPV is confirmed through the Dix–Hallpike (DH) test [8]. Auris Nasus Larynx xxx (2018) xxx–xxx * Corresponding author at: Audiology Unit, ENT Department, Faculty of Medicine, El-Gomhoria St., Mansoura 35516, Egypt. E-mail addresses: ent.mans@yahoo.com, muh@mans.edu.eg (E.I. Ismail). A R T I C L E I N F O Article history: Received 23 November 2017 Accepted 20 February 2018 Available online xxx Keywords: Particle repositioning maneuver Posterior canal benign paroxysmal positional vertigo Recurrence of benign paroxysmal positional vertigo A B S T R A C T Objective: To check the value of home particle repositioning maneuver in the prevention of the recurrence of posterior canal benign paroxysmal positional vertigo (pc-BPPV). Methods: In this study, patients diagnosed as unilateral posterior canal BPPV were selected following an accurate evaluation using video goggle VNG system. All patients were managed by particle repositioning maneuver (PRM). Patients were instructed to do home PRM once weekly for five years. Then, they were divided into two groups (according to choice of patient to do PRM). The first group (control group) consisted of 144 patients who did not do home PRM; whereas the second group (study group) included 165 patients who performed home PRM. All patients (control & study groups) were followed up every four months for five years. Results: The study found out that the recurrence rate of pc-BPPV in control group was 33 patients in the first year (27.2%), 11 patients in second year (9%), 5 patients in third year (4%), 3 patients in fourth year (2.5%) and 3 patients in fifth year (2.5%). The recurrence of pc-BPPV in the treated side (study group) of patients was reported as 5 patients in the first year (3.5%), 3 patients in the second year (2%), 2 patients in the third year (1.4%), 2 patients in the fourth year (1.4%), and 1 patient in the fifth year (0.7%). There was statistically significant difference between the control and the study groups regarding the recurrence rates in the first year follow up which was the highest in first four months. Conclusion: Home particle repositioning maneuver has the capacity to prevent the recurrence of pc- BPPV. It proved to be more successful and functional in minimizing the recurrence of the disease in the study than in the control group. Hence, home particle repositioning maneuver is highly recommended for one year at least in pc-BPPV. © 2018 Elsevier B.V. All rights reserved. G Model ANL-2421; No. of Pages 5 Please cite this article in press as: Ismail EI, et al. Home particle repositioning maneuver to prevent the recurrence of posterior canal BPPV. Auris Nasus Larynx (2018), https://doi.org/10.1016/j.anl.2018.02.005 Contents lists available at ScienceDirect Auris Nasus Larynx jo u rn al h om epag e: ww w.els evier.c o m/lo cat e/anl https://doi.org/10.1016/j.anl.2018.02.005 0385-8146/© 2018 Elsevier B.V. All rights reserved.