Li Xiaoqing, Yang Ruihu, Zhang Yihan, Ying Yaoyu, Xu Xiaomin, Gao Lidan, Li Yanjun, Shao Qiqi, Wang Wenhuan, Sun Congcong, Yang Xiaokai
Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University/Wenzhou People's Hospital, Wenzhou, 325000, Zhejiang, China.
Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.
Eur Arch Otorhinolaryngol. 2025 Jul;282(7):3525-3539. doi: 10.1007/s00405-025-09253-8. Epub 2025 Mar 4.
Benign Paroxysmal Positional Vertigo (BPPV) is a common vestibular disorder typically diagnosed and treated through head movements, which can cause discomfort for patients. More importantly, a significant cause of treatment failure is the patient's inability to tolerate these maneuvers.
To improve patient comfort while maintaining clinical efficacy, this study proposes a Minimal Stimulation Strategy (MSS), utilizing a modified Gufoni maneuver an immediate modified Epley maneuver for BPPV diagnosis and treatment.
Virtual simulation technology was employed to simulate the trajectory of otolith movement, characteristics of nystagmus, accuracy of localization, and effectiveness of repositioning during the diagnostic and therapeutic processes. This was done to evaluate the scientific validity and effectiveness of MSS in diagnosing and treating BPPV.
The modified Gufoni maneuver effectively identifies BPPV affecting the lateral and posterior semicircular canals. Bilateral application of the Gufoni maneuver enables otolith repositioning in any location within the lateral semicircular canal. The subsequent immediate application of the modified Epley maneuver effectively shortened the otolith repositioning path, reducing treatment time and discomfort.
The proposed MSS not only reduces the stimulation during the diagnostic and therapeutic process but also effectively diagnoses and treats BPPV.
良性阵发性位置性眩晕（BPPV）是一种常见的前庭疾病，通常通过头部运动进行诊断和治疗，这可能会给患者带来不适。更重要的是，治疗失败的一个重要原因是患者无法耐受这些手法。
为了在保持临床疗效的同时提高患者舒适度，本研究提出了一种最小刺激策略（MSS），采用改良的Gufoni手法和即时改良的Epley手法进行BPPV的诊断和治疗。
采用虚拟仿真技术模拟耳石运动轨迹、眼震特征、定位准确性以及诊断和治疗过程中复位的有效性。以此评估MSS在诊断和治疗BPPV中的科学有效性。
改良的Gufoni手法能有效识别影响外半规管和后半规管的BPPV。双侧应用Gufoni手法可使耳石在外半规管内的任何位置复位。随后立即应用改良的Epley手法有效缩短了耳石复位路径，减少了治疗时间和不适感。
所提出的MSS不仅减少了诊断和治疗过程中的刺激，而且能有效诊断和治疗BPPV。
