Mastoid oscillation in canalith repositioning for paroxysmal positional vertigo.

OBJECTIVE: The canalith repositioning procedure (CRP) was developed to treat paroxysmal positional vertigo (PPV). Successful CRP results in cessation of PPV and positional nystagmus. Mastoid oscillation (MO) has been advocated to enhance the efficacy of CRP. The authors sought to objectively determine the effect of MO on CRP. STUDY DESIGN: Retrospective review. SETTING: Ambulatory referral center. PATIENTS: Patients with PPV seen from 1993 through 1999 (N = 168). INTERVENTIONS: Canalith repositioning procedure performed without MO (n = 104) and performed with MO (n = 64). MAIN OUTCOME MEASURE: Presence or absence of nystagmus on Dix-Hallpike testing 6 weeks after CRP. RESULTS: Eighty-four percent of patients treated with MO had resolution, and 16% had persistent nystagmus. Seventy-three percent of patients without MO had resolution, and 27% had persistent nystagmus. Although suggesting a trend, the difference did not reach the level of significance (p = 0.151). CONCLUSIONS: Mastoid oscillation does not significantly enhance the efficacy of the CRP