Efficacy of Epley’s Maneuver versus Vestibular Sedatives in the Management of Benign Paroxysmal Positional Vertigo: A Prospective Analytical Study.

N Chetan  Rahul; Seereddi  Rachita; Praneeth  Kumar K

doi:10.51168/sjhrafrica.v6i9.2179

Authors

Dr. N Chetan Rahul Assistant Professor, Department of Otorhinolaryngology, Government Medical College, Siddipet, Telangana, India
Dr. Seereddi Rachita Senior Resident, Department of Otorhinolaryngology, Government Medical College, Siddipet, Telangana, India
Dr. Praneeth Kumar K Assistant Professor, Department of Otorhinolaryngology, Government Medical College, Siddipet, Telangana, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i9.2179

Keywords:

Benign paroxysmal positional vertigo, Epley’s maneuver, Vestibular sedatives, Dix–Hallpike test, Vertigo management

Abstract

Background:
Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder presenting with brief episodes of vertigo triggered by head movements. While vestibular sedatives are frequently used, canalith repositioning maneuvers such as Epley’s are considered more effective. This study compared the efficacy of Epley’s maneuver with vestibular sedatives in a tertiary care setting.

Methods:

A prospective analytical study was conducted at a government ENT hospital in Telangana over 24 months. Seventy-two patients aged 20–59 years with a positive Dix–Hallpike test were randomized equally into two groups: Group A (vestibular sedatives) and Group B (Epley’s maneuver). Patients were assessed at the 2nd week, 1st month, and 2nd month using the Dix–Hallpike test and Visual Analogue Scale. Outcomes were analyzed using SPSS version 23.0, with p <0.05 considered significant.

Results:

The mean age was 38.7 years, with nearly equal gender distribution. Symptomatic relief was significantly higher in Group B compared to Group A at all follow-up points: 66.7% vs. 6.7% at 2 weeks, 83.3% vs. 13.3% at 1 month, and 93.3% vs. 16.7% at 2 months (all p <0.001). Outcomes at 2 months showed 94% complete relief with Epley’s maneuver versus 16% with sedatives. Adverse events occurred only in the sedative group (hearing loss 6.6%, tinnitus 10%), while no complications were reported with Epley’s maneuver.

Conclusion:

Epley’s maneuver demonstrated superior efficacy and safety compared to vestibular sedatives in the management of BPPV, providing rapid and sustained symptom resolution.

Recommendations:

Epley’s maneuver should be considered as the first-line therapy for BPPV in clinical practice. Training primary care physicians and ENT practitioners in performing this simple, cost-effective maneuver can reduce reliance on sedatives, minimize side effects, and improve patient outcomes.

Author Biographies

Dr. N Chetan Rahul, Assistant Professor, Department of Otorhinolaryngology, Government Medical College, Siddipet, Telangana, India

MBBS, MS (ENT), is currently serving as an Assistant Professor in the Department of ENT (Otorhinolaryngology) at Government Medical College, Siddipet, Telangana, India. He completed his MBBS from NRI Medical College, Mangalagiri, Andhra Pradesh, and pursued his MS in Otorhinolaryngology at Prathima Medical College, Telangana, graduating in 2020. Following his postgraduate training, Dr. Rahul worked as a Senior Resident in the Department of ENT at Government Medical College, Siddipet, for one year, after which he was appointed as an Assistant Professor. With over four years of academic experience in this role, he has been actively involved in undergraduate teaching, clinical training, and departmental academic activities. His professional interests include rhinology, otology, and advances in endoscopic sinus and skull base surgery. Dr. Rahul is committed to evidence-based clinical practice, high-quality patient care, and fostering academic growth among medical students and young trainees. ORCID ID: https://orcid.org/0009-0002-0778-7486

Dr. Seereddi Rachita, Senior Resident, Department of Otorhinolaryngology, Government Medical College, Siddipet, Telangana, India

MBBS, MS (ENT), is currently working as a Senior Resident in the Department of Otorhinolaryngology (ENT) at Government Medical College, Siddipet, Telangana, India. She completed her M.B.B.S. from Andhra Medical College, Visakhapatnam (2014 batch), and obtained her M.S. in Otorhinolaryngology from Osmania Medical College, Hyderabad (2021–2022 batch). Her academic interests include vestibular disorders, endoscopic sinus surgery, and otology. Dr. Rachita is actively engaged in clinical research and patient care, with a commitment to advancing evidence-based practice in ENT.

Dr. Praneeth Kumar K, Assistant Professor, Department of Otorhinolaryngology, Government Medical College, Siddipet, Telangana, India

MBBS, MS (ENT), is serving as an Assistant Professor in the Department of ENT (Otorhinolaryngology) at Government Medical College, Siddipet, Telangana, India. He obtained his MBBS degree from Kakatiya Medical College, Warangal, and pursued his postgraduate training in Otorhinolaryngology (MS ENT) at the prestigious Osmania Medical College, Hyderabad. With more than eight years of teaching experience as an Assistant Professor, Dr. Praneeth Kumar has been actively involved in undergraduate and postgraduate medical education, clinical training, and mentorship.

He has published two research papers in peer-reviewed journals and continues to contribute to academic scholarship in otorhinolaryngology. His areas of clinical and research interest include allergic rhinitis, endoscopic sinus surgery, and advances in otology and laryngology. In addition to his academic contributions, Dr. Praneeth Kumar is dedicated to patient-centered clinical practice and strives to integrate evidence-based medicine into daily teaching and healthcare delivery. ORCID ID: https://orcid.org/0009-0007-1056-815X

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