![]() Interpretation: This prospective trial shows that SM+ is more effective than SM when repeated therapeutic maneuvers are performed but not when a single maneuver is performed. There was no difference in the second primary endpoint (chi 2-test, p = 0.39). Results: In the 194 patients analyzed (96 SM, 98 SM+), it took 2 days (median, range 1–21 days, mean 3.6 days) for recovery with SM and 1 day (median, range 1-8 days, mean 1.8 days) with SM+ ( p = 0.001, Mann-Whitney U-test). The primary endpoints were: “How long (in days) does it take until no attacks can be induced?” and “What is the efficacy of a single SM/SM+?” ![]() Each morning the patient documented whether vertigo could be induced. The first maneuver was done by the physician, and the subsequent maneuvers by the patients 9 times/day on their own. Methods and Patients: In a prospective trinational (Germany, Italy, and Belgium) randomized trial, patients with pcBPPVcan were randomly assigned to SM or SM+ SM+ means overextension of the head by 60+° below earth horizontal line during the movement of the patient toward the affected side. Objective: To compare the efficacy of the Sémont maneuver (SM) with the new “SémontPLUS maneuver” (SM+) in patients with posterior canal BPPV canalolithiasis (pcBPPVcan). 5ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.4Department of Otolaryngology, University of Siena, Siena, Italy. ![]() 2Department of Otolaryngology, Algemeen Ziekenhuis Brugge, Brugge, Belgium.1Department of Neurology, German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany.Michael Strupp 1 * † Nicolina Goldschagg 1 † Anne-Sophie Vinck 2 Otmar Bayer 1,3 Sebastian Vandenbroeck 2 Lorenzo Salerni 4 Anita Hennig 1 Dominik Obrist 5 Marco Mandalà 4
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