外側半規管型良性発作性頭位めまい症に対する耳石置換法

抄録

　Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo, and most types of BPPV are treatable. Apogeotropic horizontal semicircular canal BPPV (AH-BPPV) is a syndrome characterized by apogeotropic horizontal direction-changing nystagmus found on the supine-roll test; it is a rather intractable type of BPPV, and while various otolith repositioning procedures have been proposed, there is no established treatment method such as the Epley maneuver used to treat the posterior semicircular canal type of BPPV. Gufoni and Appiani have proposed otolith repositioning procedures for AH-BPPV; the two maneuvers appear to be close, but are actually different. Gufoni et al. first described using the new repositioning maneuver in Italians in 1998 for both horizontal semicircular canal-type BPPV, namely AH-BPPV, and geotropic horizontal semicircular canal-type BPPV (GH-BPPV). The Gufoni maneuver was modified by Appiani in 2005, and Appiani used the Gufoni maneuver for GH-BPPV after using the Appiani maneuver for treating AH-BPPV when the otolith detached from the cupula. These maneuvers used to treat AH-BPPV were complicated, so that there has been confusion in the naming of and methods used to perform these maneuvers. Some authors have described the Gufoni maneuver as the modified Semont maneuver, and other authors have described the Appiani maneuver as the Gufoni maneuver.

　Herein, we would like to summarize the transition of the otolith repositioning procedures for AH-BPPV over time and in the naming of the procedures.