Treatment for BPPV, anterior canal, right side, Garaycochea maneuver

By Marcello Cherchi, MD PhD

The maneuver developed by Dr. Octavio Garaycochea and colleagues (Garaycochea et al. 2022) is intended to treat anterior canal BPPV.

The Garaycochea maneuver for treating right-sided anterior canal BPPV is displayed in the Figure below.

The Garaycochea maneuver for treating right-sided anterior canal BPPV can be described as follows:

1. The patient starts in a neutral seated position.
2. The patient inclines the head anteriorly by 45 degrees (tucking the chin toward the chest).
3. The patient rotates the head 45 degrees toward the unaffected (left) side, with the head/neck still flexed anteriorly by 45 degrees.
4. The patient leans the torso forward by 90 degrees such that the head is approximately at the level of the knees, maintaining the position of the head relative to the torso from the previous position. This position is maintained for 1 minute.
5. The patient slowly rotates the head 90 degrees toward the affected (right) side, such that it is facing 45 degrees off the midline toward the affected (right) side.
6. The patient sits up, maintaining the head rotated 45 degrees toward the affected (right) side and 45 degrees downward.
7. The patient rotates the head to the midline, still flexed anteriorly by 45 degrees.
8. The patient resumes an neutral seated position.

Garaycochea maneuver, right anterior canal, videos

• As of this writing we had not identified any adequate videos of this maneuver.

References

Garaycochea O, Perez-Fernandez N, Manrique-Huarte R (2022) A novel maneuver for diagnosis and treatment of torsional-vertical down beating positioning nystagmus: anterior canal and apogeotropic posterior canal BPPV. Braz J Otorhinolaryngol 88: 708-716. doi: 10.1016/j.bjorl.2020.09.009