1) The Gufoni maneuver is a treatment for horizontal canal benign paroxysmal positional vertigo (BPPV) that uses quick changes in head position to move loose particles in the inner ear.
2) Studies have found the Gufoni maneuver has a higher success rate for treating horizontal canal BPPV compared to other maneuvers like the barbecue roll, with over 80% of patients finding relief after one session.
3) The Gufoni maneuver is easy for patients to perform and tolerable even for those with limited mobility, making it a suitable first-line treatment for horizontal canal BPPV.
1) The Gufoni maneuver is a treatment for horizontal canal benign paroxysmal positional vertigo (BPPV) that uses quick changes in head position to move loose particles in the inner ear.
2) Studies have found the Gufoni maneuver has a higher success rate for treating horizontal canal BPPV compared to other maneuvers like the barbecue roll, with over 80% of patients finding relief after one session.
3) The Gufoni maneuver is easy for patients to perform and tolerable even for those with limited mobility, making it a suitable first-line treatment for horizontal canal BPPV.
1) The Gufoni maneuver is a treatment for horizontal canal benign paroxysmal positional vertigo (BPPV) that uses quick changes in head position to move loose particles in the inner ear.
2) Studies have found the Gufoni maneuver has a higher success rate for treating horizontal canal BPPV compared to other maneuvers like the barbecue roll, with over 80% of patients finding relief after one session.
3) The Gufoni maneuver is easy for patients to perform and tolerable even for those with limited mobility, making it a suitable first-line treatment for horizontal canal BPPV.
1) The Gufoni maneuver is a treatment for horizontal canal benign paroxysmal positional vertigo (BPPV) that uses quick changes in head position to move loose particles in the inner ear.
2) Studies have found the Gufoni maneuver has a higher success rate for treating horizontal canal BPPV compared to other maneuvers like the barbecue roll, with over 80% of patients finding relief after one session.
3) The Gufoni maneuver is easy for patients to perform and tolerable even for those with limited mobility, making it a suitable first-line treatment for horizontal canal BPPV.
The most common cause of vertigo Causes Canalolithiasis: dislodged otoconia floating in the semicircular canals Cupulolithiasis: otoconia are attached to the cupula, situated in the ampulla
The most commonly affected semicircular canal is the
posterior canal Horizontal canal BPPV accounts for 5% to 22% of cases Horizontal canal BPPV Two types of BPPV involving the horizontal canal
Geotropic nystagmus: Otoconia situated in the posterior segment of the lateral canal (canalolithiasis) More intense when the head is turned toward the affected ear
Apogeotropic nystagmus: Otoconia attached to the cupula (cupulolithiasis) Free-floating within the anterior arm of the horizontal semicircular canal near the cupula (canalolithiasis). More intense when the head is turned toward the healthy ear. Treatment of Lateral Canal BPPV
Maneuvers designed to detach the otolithic debris from the
cupula or to move the debris from the anterior arm of the horizontal canal to the posterior arm
Lateral canal BPPV with geotropic nystagmus is more
responsive to treatment
The maneuvers for treatment of lateral canal BPPV
Angular accelerations (roll maneuvers, barbecue roll) Slow gravitational sedimentation (forced prolonged positioning) Sudden linear accelerations (Gufoni maneuver) Gufoni Maneuver First described in 1998.
For geotropic nystagmus
Patient quickly lies down on the side of the unaffected ear and remains in this position for 1 to 2 minutes, until the evoked nystagmus subsides. The head is then quickly rotated 45 degrees toward the floor and kept in this position for another 2 minutes, after which the patient resumes an upright position
For apogeotropic nystagmus
Patient quickly lies down on the affected side and remains in this position for 1 to 2 minutes after the nystagmus has stopped or has been markedly reduced. Then the head is quickly turned 45 degrees toward the ceiling and is held in this position for 2 minutes, after which the patient slowly resumes the sitting position Gufoni Maneuver For the geotrophic variant one starts on the unaffected side (side of weaker nystagmus), and then proceeds to 45 degree nose down
For the ageotrophic variant
one starts on the affected side (side of weaker nystagmus), and proceeds to 45 degree nose up.
不論哪一種眼振，皆往弱的那一側躺 Geotrophic type 往地轉，Apogeotrophic 離地轉，每動兩分鐘。 Vannucchi’s forced prolonged position Barbecue maneuver + forced prolonged position (FPP) vs Gufoni maneuver.
From January 2001 to June 2008
147 patients affected by HSC-BPPV
103 Geotrophic type and 44 Apogeotrophic type The higher percentage of success (statistically significant) with the Gufoni maneuver at the first session of treatment (86 vs. 61%).
The final control showed that 44 out of 54 (81%) patients
treated with the barbecue maneuver + FPP were symptom free compared to 54 out of 58 (93%) treated with the Gufoni maneuver. The most evident result is the higher percentage of success (statistically significant) with the Gufoni maneuver at the first session of treatment (86 vs. 61%).
Both the barbecue maneuver + FPP and the Gufoni
maneuver are valid methods for treating HSC-BPPV (geotropic forms). a success rate of over 80% at the follow-up on the 30th day. Conclusions The Gufoni maneuver has a significant advantage over the barbecue method: the success rate shown at the follow-up, while without statistical significance, is undoubtedly higher (93% compared with 81%) the disorder is more quickly cured with the Gufoni maneuver (86 of the subjects treated in this manner were symptom-free after the first session compared with 61% of those who underwent the barbecue + FPP method).
It is very easy to perform and that patient compliance is
better, especially if they are affected with some disorder that limits their movement, with Gufoni maneuver Prospective clinical study 60 patient diagnosed with HSC canalithiasis (Bilateral geotropic nystagmus) Baloh’s maneuver (n = 13), Vannucchi’s forced prolonged position (n = 29), Asprella-Gufoni maneuver (n = 18). Results & Conclusions The Asprella-Gufoni maneuver and Vannucchi’s forced prolonged position both seem to be significantly more effective than the Baloh’s maneuver in the treatment of HSC canalithiasis. with success rates of 76% and 89%, respectively, vs. 38%
The important pros of the Asprella-Gufoni maneuver versus
Vannucchi’s forced prolonged position Patient’s convenience and maximal use of gravitational and angular acceleration forces. Double-blind randomized controlled trial.
Gufoni Maneuver vs Sham maneuver
Seventy-two patients with unilateral LC-BPPV
Patients were randomly assigned to treatment by Gufoni Maneuver (n = 37) or
sham treatment (n = 35).
Subjects were followed up twice (at 1 hour and 24 hours) with the supine roll test by blinded examiners. Results & Conclusion At 1- and 24-hour follow-up, 75.7% and 83.8% of patients, respectively, undergoing Gufoni maneuver had recovered from vertigo Compared to around 10% of patients undergoing the sham maneuver (P < 0.0001).
The first class I study on the efficacy of the Gufoni maneuver in the treatment of LC-BPPV in both geotropic and apogeotropic forms.
The level of recommendation of the Gufoni maneuver for treating
LC-BPPV from level U to level B for the geotropic variant from level B to level A for the apogeotropic variant Conclusion There is some evidence for a significant positive effect of the Gufoni maneuver to treat patients with lateral canal BPPV with geotropic nystagmus.
The maneuver is easy to perform and, therefore, particularly
suitable for older, immobile, and obese patients.
However, at present, there are insufficient data to establish
the relative efficacy of this maneuver in comparison to other maneuvers. Thank You
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Evidence-Based Review) : Report of The Quality Standards Subcommittee of The Practice Parameter: Therapies For Benign Paroxysmal Positional Vertigo (An
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