The physical treatment of lateral semicircular canal canalolithiasis

Abstract The authors describe the different techniques for physical therapy of benign paroxysmal positional vertigo of the lateral semicircular canal. All are based on one of three mechanisms: barbeque manoeuvres in which the canals are quickly rotated, so that material heavier than endolymph is induced to move toward the vestibule; repositioning manoeuvres in which debris is induced to move under the force of gravity; brisk deceleration manoeuvres in the plane of the affected canal in which debris is induced to move out of the canal. The authors report good results from different techniques and they suggest a strategy for the treatment of LSC-BPV; they prefer manoeuvres which can bring about immediate recovery. After a few days, it is useful to see patients again, because LSC-BPV may transform into PSC-BPV.