The BPPV-project

BPPV is the most common disease in the vestibular organs. It is caused by otoliths that are displaced to the semicircular canals in the inner ear – most frequently the posterior canal. When the orientation of the head changes relative to gravity, the otoliths move resulting in a brief, severe sensation of spinning (vertigo) often accompanied by nausea. Diagnostics and treatment are performed by a sequence of different head positions that provoke movement of the displaced otoliths. These movements are executed with a high degree of inter- and intra-personal variation, and diagnostics and treatment of BPPV are therefore often associated with challenges.

During the last decade state-of-art technology like videonystagmography (VNG goggles) and mechanical rotational chair (i.e., the TRV chair like we use in this project) have improved the possibilities for diagnostics and treatment of BPPV. This project is a prospect to optimize diagnostics and treatment of BPPV further. The project is divided into two substudies: One focusing on the diagnostics of BPPV and one focusing on the treatment of BPPV.



The diagnostic efficacy of manual bedside examination compared to diagnostics in the mechanical rotational chair when using videonystagmography goggles in both scenarios.

This study is an open-label randomized controlled trial with cross-over with 203 adults suspected of having BPPV based on their symptoms. Every patient is examined for BPPV with both manual bedside examination and diagnostics in the mechanical rotational chair. Both scenarios include the use of videonystagmography (VNG) goggles. Randomization determines which diagnostic modality is performed first. Data will be evaluated by measuring diagnostic parameters as sensitivity, specificity, positive predictive value, and negative predictive value. Secondary, we will determine the significance of correct angulation and angular velocity in relation to the diagnostic outcome when performing manual examination.



Does the 360° maneuver improve treatment of posterior BPPV compared to the Epley maneuver in the mechanical rotational chair?

This study is an open-label randomized controlled trial comparing two treatment maneuvers (Epley and 360°) for posterior BPPV in the mechanical rotational chair. The study includes 128 adults diagnosed with posterior BPPV (p-BPPV). We will compare outcome measures as treatment success, patient reported outcome, and recurrence rate.