Epley Versus Semont-plus Maneuver for Benign Paroxysmal Positional Vertigo

Efficacy of the Epley Versus Semont-plus Maneuver in Patients With Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo: A Randomized Controlled Trial Using Quantitative Video-Nystagmography Measurement

The goal of this clinical trial is to learn which of two head-movement treatments works better for benign paroxysmal positional vertigo (BPPV) of the posterior canal in adults. BPPV is a common cause of short spells of spinning dizziness. It happens when tiny crystals come loose inside the balance organ of the inner ear and drift into one of its canals. Changing head position then brings on a spinning feeling, along with quick jerking movements of the eyes.

The main question it aims to answer is:

* Does one treatment reduce these jerking eye movements more than the other, measured before treatment, 30 minutes after treatment, and 3 days after treatment?

The study will also look at:

• How many participants become free of positional dizziness after treatment
• How many days pass before the dizziness stops
• Whether repeating the treatment at home more times a day shortens recovery
• How often unwanted effects, such as nausea or vomiting, happen with each treatment

Researchers will compare the Semont-plus maneuver to the Epley maneuver, the long-standing standard treatment, to see if it clears the crystals out of the canal faster and more completely.

Participants will:

• Be placed by chance, into the Epley group or the Semont-plus group
• Have the jerking movements of the eyes recorded with video goggles while the doctor moves their head into the position that brings on the dizziness
• Receive their assigned maneuver at the hospital, followed by a second recording about 30 minutes later
• Be taught to carry out the same maneuver on their own at home, as often as they feel able to
• Come back after 3 days for another recording of their eye movements
• Come back after 1 month to talk with the study team about how their dizziness changed over that time
• Keep a short daily diary of their dizziness and of how many times a day they did the maneuver at home

Study Overview

• Status: Not yet recruiting
• Conditions: Benign Paroxysmal Positional Vertigo (BPPV)
• Intervention / Treatment: Procedure: Semont-plus; Procedure: Epley

• Study Type: Interventional
• Enrollment (Estimated): 160
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Vietnam
  • Ho Chi Minh City, Vietnam
    • Military Hospital 175
    • Contact: Chau Van Ha; Phone Number: (+84) 0963219277; Email: hachau.ht89@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age 18 years or older
• Posterior semicircular canal benign paroxysmal positional vertigo of the canalolithiasis type, diagnosed according to the Barany Society 2015 diagnostic criteria
• Unilateral involvement of a single semicircular canal

Exclusion Criteria:

• Involvement of more than one semicircular canal
• Any condition making the repositioning maneuver unsafe, including severe cervical spine disease with restricted range of motion or instability, previous cervical spine fracture, severe osteoporosis, unstable cardiovascular disease, or respiratory failure
• Unable to cooperate with the maneuver
• Any ocular or neurologic condition preventing technically adequate videonystagmography recording, such as inability to keep the eyes open, severe ptosis, or interfering spontaneous nystagmus from another cause

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Semont-Plus	Procedure: Semont-plus; Semont-plus liberatory maneuver for posterior canal BPPV, performed by a trained therapist at the enrolment visit. From the upright seated position the head is turned 45 degrees toward the nonaffected side. The body is then moved 150 degrees toward the affected side, so that the head comes to lie about 60 degrees below the earth horizontal and the otoconia are carried beyond the vertex of the canal. The body is next moved 240 degrees toward the nonaffected side, which drives the otoconia toward the vestibule, and the participant is finally brought 90 degrees back to the upright position. Each position is held for about one minute or until the induced nystagmus stops. The maneuver is repeated within the same session if positional nystagmus persists. Participants are then taught to perform it on their own at home, as often as they are able, and to record each home session in a diary.
Active Comparator: Epley	Procedure: Epley; Epley maneuver for posterior canal BPPV, performed by a trained therapist at the enrolment visit. From the upright seated position the head is rotated 45 degrees toward the affected ear. The body is then moved backward so that the head hangs below the earth horizontal. The head is rotated 90 degrees toward the nonaffected ear, after which the whole body is rotated downward until the participant faces the floor with the affected ear pointing toward the ceiling. The participant returns to sitting with the head still rotated 45 degrees toward the nonaffected ear, and the head is turned back to neutral at the end. Each position is held until the induced nystagmus stops, and for at least 30 seconds. The maneuver is repeated within the same session if positional nystagmus persists. Participants are then taught to perform it on their own at home, as often as they are able, and to record each home session in a diary.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Change in average slow-phase velocity of positional nystagmus	Before the maneuver, 30 minutes after the maneuver, and 3 days after the maneuver

Secondary Outcome Measures

Outcome Measure	Time Frame
Proportion of participants with a successful repositioning maneuver	30 minutes and 3 days after the first treatment maneuver
Number of days until resolution of positional vertigo	From the enrolment visit (day 0) to 1 month
Number of participants with adverse events during treatment	From the enrolment visit (day 0) to 1 month
Correlation between the number of self-administered maneuvers per day and time to resolution of positional vertigo	From the enrolment visit (day 0) to 1 month

Collaborators and Investigators

• Sponsor: Military Hospital 175

Study record dates

Study Major Dates

• Study Start (Estimated): September 1, 2026
• Primary Completion (Estimated): October 30, 2027
• Study Completion (Estimated): November 30, 2027

Study Registration Dates

• First Submitted: August 22, 2026
• First Submitted That Met QC Criteria: August 22, 2026
• First Posted (Actual): August 26, 2026

Study Record Updates

• Last Update Posted (Actual): August 27, 2026
• Last Update Submitted That Met QC Criteria: August 25, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Otorhinolaryngologic Diseases; Ear Diseases; Labyrinth Diseases; Vestibular Diseases; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Vertigo; Benign Paroxysmal Positional Vertigo
• Other Study ID Numbers: DTCSHY.24/26/175.A7

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No