* MBChB, KBMS(ENT) trainee ENT, Head & Neck surgery. Email: hemnyaseen1981@gmail.com ** Assist. Prof. Senior consultant surgeon F.I.C.M.S (ENT), C.A.B.S (ORL-Head and Neck surgery). https://amj.khcms.edu.krd/ /https://doi.org/10.56056/amj.2022.169 Advanced Medical Journal, Vol.7, No.1, P.129-137, 2022 129 The Efficacy of Epley Maneuvers in the Management of Subjective Benign Paroxysmal Positional Vertigo in Sulaimany Governorate Hemn Yaseen Mohammed * Yousif Ibrahim Al Chalabi ** Abstract Background and objectives: Benign paroxysmal positional vertigo is vestibular disorder with most frequent episodes. It is mostly idiopathic. Epley maneuver gives good results in most patients. The aim of this study is to confirm the diagnoses of benign paroxysmal positional vertigo by Dix-Hall pike test. And to evaluate the effectiveness of Epley maneuver in treating patients with this disorder. Methods: A prospective study conducted on (100) patients with benign paroxysmal positional vertigo, in Sulaimany training Center for Otolaryngology-Head and Neck surgery, Kurdistan audiological centre from September 2018 to November 2019. Those with induced vertigo without nystagmus were included in the study. All patients had undergone complete ear nose and throat and audiological assessment, diagnoses were confirmed by Dix Hallpike test. The maneuver was performed weekly over 4 weeks and the results were recorded accordingly. Results: Twenty eight patients were males (28%), seventy two patients were females (72%). Age ranged between 18 and 72 years. Mean age (42.23). There was complete recovery in (82%), partial r e c o v e r y in (13%), and resistance in (5%) these values were significant statistically. Conclusions: Epley maneuver gave good results in management of benign paroxysmal positional vertigo and is a safe procedure without complications. Dix hallpike test gave a definite diagnosis of benign paroxysmal positional vertigo particularly the posterior canal. Keywords: Benign paroxysmal positional vertigo, Dix-Hallpike test, Epley maneuver. Introduction Benign paroxysmal positional vertigo (BPPV) is the commonest cause of vertigo with prevalence of 2.4% 1 . It is characterized by brief spells (lasting seconds) of severe vertigo after specific head movement of which rolling over in bed and extension of the head is the most common 2 .The causes are mostly idiopathic (58%), head trauma (6%–18%), inner-ear disease (3%–9%) 3 . The trauma force may cause otoconial release into endolymph. It was first described by Barany in 1921, Dix and Hall pike in 1952 4 . The pathophysiology of BPPV either: canalolithiasis or cupulolithiasis. Cupulolithiasis described cupula attached particles. Canalolithiasis is free-floating particles within semicircular canal (SCC), and the majorities are posterior cacanalolithiasis 5 . Patients with BPPV present with rotational vertigo, lightheadedness, unsteadiness, blurred vision, nausea and vomiting, without hearing loss or tinnitus. The Dix-Hall pike (D-H) test is used in both the diagnosis, short- and long-term follow up. It is done with the patient in sitting position on a flat table; the examiner turns the patient’s head 45°one side, then rapidly, but smoothly lays the patient into a supine position, with the head hanging about 20° over the table end, observes patient’s eyes for 30 seconds. The maneuver is repeated with the head turned to the opposite side. The result is positive if