By Marcello Cherchi, MD PhD
The maneuver developed by Dr. Francisco Carlos Zuma e Maia (Zuma e Maia 2016) was originally designed to treat apogeotropic lateral canal BPPV. Ramos and colleagues (Ramos et al. 2021) created a modified Zuma maneuver to treat geotropic lateral canal BPPV.
As of this writing we had not identified any adequate illustrations of this maneuver.
This maneuver can be described as follows:
- The patient starts in a neutral seated position.
- The patient turns the head 45 degrees toward the unaffected (right) side. (This head turn differs from the regular Zuma maneuver.)
- The patient lies down on the affected (left) side, with the head still turned 45 degrees toward the unaffected side (with the nose pointing half-way between the surface of the earth and the sky). This position is maintained for 3 minutes.
- The patient lies supine and turns the head such that the nose is pointing directly at the sky. This position is maintained for 3 minutes.
- While the torso remains supine, the patient turns the head 90 degrees toward the unaffected (right) side, such that the nose is pointing in the plane of the earth’s surface.
- The patient tilts the head up and slightly forward, then slowly returns to a seated position.
Modified Zuma maneuver, geotropic lateral canal BPPV, left side, videos
- https://www.youtube.com/watch?v=S7AS36pnxm0 (360NeuroHealth)
The modified Zuma maneuver has been studied in a prospective trial without a control group (Ramos et al. 2021).
References
Ramos BF, Cal R, Brock CM, Mangabeira Albernaz PL, Zuma EMF (2021) Zuma Modified Maneuver as a Treatment to Geotropic Lateral Semicircular Canal Benign Paroxysmal Positional Vertigo. Int Arch Otorhinolaryngol 25: e255-e257. doi: 10.1055/s-0040-1712935
Zuma e Maia F (2016) New Treatment Strategy for Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo. Audiol Res 6: 163. doi: 10.4081/audiores.2016.163
