International Session 14　　Vestibule 1

Objective : To compare automated canalith repositioning maneuvers(Automated-CRM)with manual CRM in benign paroxysmal positional vertigo(BPPV) .Methods : In this prospective multicenter randomized trial, 404 unilateral BPPV patients from three tertiary hospitals in China were assigned 1 : 1 to Automated-CRM(n＝201)or Manual-CRM(n＝203) .Participants and examiners were unblinded ; outcome assessors and statisticians were masked.The primary end point was response(cured or improved)at week 1.Secondary end points were immediate and weekly response and cure rates through week 4 and safety.Results : At week 1, response was higher with Automated-CRM than Manual-CRM(97． 51％ vs 86． 70％, P＜0． 001); sustained response through week 2 also favored Automated-CRM(98． 51％ vs 93． 60％) .Generalized estimating equations showed higher odds for response(OR 6． 13, 95％ CI 3． 16-11． 82)and cure(OR 1． 44, 95％ CI 1． 06-1． 95)with Automated-CRM.Adverse events were similar(39 events in 31 vs 32 in 28 participants) .Conclusions : Automated-CRM yields faster and more durable symptom relief than Manual-CRM without increasing adverse events and may be considered first-line therapy for BPPV.