Management of benign paroxysmal positional vertigo of lateral semicircular canal by Gufoni's manoeuvre Riggio Francesco, MD, PhD a , Dispenza Francesco, MD a, ⁎ , Gallina Salvatore, MD, PhD a , Kulamarva Gautham, MS, DNB, MRCS, DOHNS b , Gargano Rosalia, MD, PhD a , Speciale Riccardo, MD a a Dipartimento Scienze Otorinolaringoiatriche, Università degli Studi di Palermo, Palermo, Italy b ENT Clinic Nayak's Road, Kasaragod, India Received 7 January 2008 Abstract Benign paroxysmal positional vertigo (BPPV) of lateral semicircular canal (LSC) is one of the rarer forms of BPPVas compared to posterior semicircular canal BPPV. Various particle repositioning manoeuvres have been described in the literature as a mode of treating this condition. Purpose: Evaluation and discussion of the procedure of the Gufoni's manoeuvre and its advantages in the treatment of BPPV of LSC. Material and methods: Prospective study of 58 patients affected by LSC BPPV who were office- treated with Gufoni's manoeuvre. Results: Seventy-nine percent of the patients so treated had complete resolution of symptoms, and 6.9% did not show any improvement in their symptoms. The remaining 13.8% had a conversion into posterior semicircular canal BPPV during treatment and were successfully treated with Epley's or Semont's manoeuvre. Conclusions: Gufoni's manoeuvre is effective in treating patients suffering from BPPV of LSC; it is simple to perform; there are not many movements to execute, it needs low time of positioning, and positions are comfortable to the patient. © 2009 Elsevier Inc. All rights reserved. 1. Introduction Any patient presenting with history of vertigo is a challenge for the ear, nose, and throat (ENT) specialist. Vertigo affects the patients both physically and psychologi- cally as it becomes impossible for the patient to go through daily routines of life without external help from others. Many of these patients are usually managed by primary care physicians medically for a long time before they are referred to an ENT surgeon. Because of this reason, they have to go through several unnecessary diagnostic procedures before arriving at a diagnosis or being referred further to a specialist centre. Fortunately, in patients affected by vertigo crisis due to benign paroxysmal positional vertigo (BPPV), correct diagnostic evaluation and appropriate management allows, in the great number of cases, to solve the problem quickly, without the need for any medical treatment. Benign paroxysmal positional vertigo is the most common cause of peripheral vertigo [1]. It accounts for approximately 24% of all cases of peripheral vestibular disorders [2]. This type of vertigo is generally seen in individuals aged 40 years and older with the highest age distribution between 50 and 70 years [3]. The exact etiology of BPPV is still under debate. More than 50% of all reported cases are idiopathic in nature [4]. Classic BPPV involves the posterior semicircular canal (PSC) and represents the most common type of BPPV [3,5-7]. Lateral semicircular canal (LSC) BPPV accounts approximately for only 10–20% of all the patients presenting with BPPV [8]. In addition, treatment Available online at www.sciencedirect.com American Journal of Otolaryngology–Head and neck Medicine and Surgery 30 (2009) 106 – 111 www.elsevier.com/locate/amjoto ⁎ Corresponding author. Dipartimento Scienze Otorinolaringoiatriche, Università degli Studi di Palermo, 90127 Palermo, Italy. Tel.: +393334565471. E-mail address: francesco-dispenza@libero.it (D. Francesco). 0196-0709/$ – see front matter © 2009 Elsevier Inc. All rights reserved. doi:10.1016/j.amjoto.2008.03.001