How to perform the Gufoni Maneuver
What is the Gufoni maneuver?
The Gufoni maneuver, also known as the Appiani maneuver, is a therapeutic technique used to treat lateral (horizontal) canal benign paroxysmal positional vertigo (BPPV). Its purpose is to reposition any dislodged otoconia from the semicircular canals back to the utricle, where they no longer cause symptoms of dizziness or vertigo.
Important considerations
Before performing any form of positioning maneuver, it is important to ascertain whether the patient has current or past injuries of the neck or spine.
If any neurological symptoms occur during the execution of positioning maneuvers, discontinue the procedure immediately and refer for neurological evaluation. These symptoms might include blurred vision, numbness, weakness of the arms or legs, or confusion.
This procedure is an alternative treatment for patients who cannot complete the Lempert (BBQ) Roll, as well as for cases where an apogeotropic lateral canal variant may be present.
Gufoni maneuver procedure
Begin with the patient sitting on the edge of the examination table, facing the examiner.
With a rapid motion, guide the patient into a side-lying position toward the unaffected side.
While the patient is lying on their side, with a quick movement, turn the patient’s head to a 45-degree angle (so that the patient’s nose is pointing toward the table).
Hold this position for two to three minutes, after which you should guide the patient back into a sitting position.
Further reading
Gufoni, M., Mastrosimone, L., & Di Nasso, F. (1998). Trattamento con manovra di riposizionamento per la canalolitiasi orizzontale [Repositioning maneuver in benign paroxysmal vertigo of horizontal semicircular canal]. Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale, 18(6), 363–367.
Ciniglio Appiani, G., Catania, G., & Gagliardi, M. (2001). A liberatory maneuver for the treatment of horizontal canal paroxysmal positional vertigo. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 22(1), 66–69.
Hughes, C. A., & Proctor, L. (1997). Benign paroxysmal positional vertigo. The Laryngoscope, 107(5), 607–613.
