Abstract Objective To evaluate video head impulse testing (vHIT) outcomes in patients with benign paroxysmal positional vertigo (BPPV) before canalith repositioning maneuver (CRM), immediately after treatment, and 1 week post-treatment. Study design Prospective before–after study. Setting Tertiary referral center. Patients Of 156 patients with vertigo and positional nystagmus, 63 were diagnosed with BPPV using standard maneuvers; 51 had posterior canal BPPV, 11 had lateral canal BPPV and 1 had anterior canal BPPV. All underwent vHIT to assess vestibulo-ocular reflex (VOR) gain across all 6 semicircular canals and completed the Dizziness Handicap Inventory before and after treatment. Interventions CRMs specific to the affected canal. Main outcome measures VOR gain and Dizziness Handicap Inventory scores before and after CRM. Results At pre-treatment, 59 patients (93.7%) exhibited VOR gains within normative limits. Only four patients (6.3%) showed decreased VOR gains, all of whom were diagnosed with posterior canal BPPV. VOR gain did not differ significantly across pre-treatment, immediate post-treatment, and 1-week assessments. No corrective saccades were detected. Conclusions vHIT showed no significant post-treatment changes and may have limited incremental value in the routine evaluation of isolated BPPV cases.
Vongviriyangkoon et al. (2026) studied this question.