The Epley canalith repositioning maneuver for posterior canal BPPV sequentially moves the patient through which positions to reposition otoconia from the posterior canal into the utricle?

• A Semont liberatory maneuver (rapid side-to-side roll without head turn)
• B Dix-Hallpike unaffected side → supine with neck extended → Dix-Hallpike affected side → seated
• C Barbecue roll (series of 90° rotations toward unaffected side) in supine position
• D Dix-Hallpike affected side → 45° head turn toward unaffected side supine → lateral decubitus unaffected side → seated upright ✓

Explanation

The Epley canalith repositioning maneuver for posterior canal BPPV proceeds through: (1) Dix-Hallpike position with affected ear down to bring otoconia to the common crus, (2) head rotation 90° toward the unaffected side while supine to move debris toward the common crus, (3) lateral decubitus unaffected side (head at 45°) to move debris to the common crus/utricle opening, and (4) sitting up. This sequence guides canalith debris out of the posterior canal into the utricle. The Barbecue roll is for horizontal canal (cupulolithiasis) BPPV.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.