Diagnosis strategy and Yacovino maneuver for anterior canal-benign paroxysmal positional vertigo

To investigate the diagnosis strategy of anterior canal-benign paroxysmal positional vertigo (AC-BPPV) and the therapeutic effects of the Yacovino maneuver. The clinical data of 40 AC-BPPV patients were collected. The nystagmus characteristics induced by the Dix–Hallpike (D–H) and straight head-hanging (SHH) tests, the diagnostic methods used, and the effectiveness of the Yacovino maneuver for the treatment of AC-BPPV were all retrospectively analyzed. Among the 40 cases analyzed, 19 patients had simple AC-BPPV, 11 patients had AC-posterior canal BPPV, and 10 patients had AC-horizontal canal BPPV. D–H and SHH tests showed down-beating nystagmus in 26 and 33 patients, respectively, and showed down-beating and torsional nystagmus in 14 and 7 patients, respectively. AC-BPPV was diagnosed in 15 patients based on the presence of typical BPPV in other canals, in 9 patients based on typical disease history and the results of position tests, in 6 patients based on effectiveness of the treatment with the Yacovino maneuver, in 4 patients based on the treatment effectiveness and the presence of typical BPPV in other canals, in 3 patients based on the treatment effectiveness and the follow-up outcome, in 2 patients based on the typical BPPV in other canals and occurrence of canal conversion, and in 1 patient based on the treatment effectiveness and occurrence of canal conversion. Thirteen patients with canalolithiasis and four patients with cupulolithiasis were cured after the initial Yacovino maneuver treatment. Twenty-one patients with canalolithiasis and seven patients with cupulolithiasis were cured following 1 week of treatment. The effectiveness of the Yacovino maneuver, the follow-up outcome, the presence of typical BPPV in other canals, and the occurrence of canal conversions contribute to AC-BPPV diagnosis. The Yacovino maneuver was found to be more effective in AC-BPPV patients with canalolithiasis than in those with cupulolithiasis.