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Comments on an Update of Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo

Xizheng Shan,Amy Wang,Entong Wang*

The clinical practice guideline for benign paroxysmal positional vertigo (BPPV) is newly updated by the American Academy of Otolaryngology—Head and Neck Surgery Foundation. The guideline will guide clinicians to manage BPPV in their clinical practice. But some descriptions in the Statement 1a and Statement 1b of the guideline seem not quite clear or appropriate, which would make clinicians have some misunderstandings. Thus we present our opinions: 1) the Dix-Hallpike test should be repeated on the opposite side no matter the test on initial side is negative or positive due to possible presence of bilateral posterior canal BPPV; and 2) no matter the bilateral Dix- Hallpike tests are negative or positive, the supine roll test should be followed due to possible presence of multicanal BPPV variation with involvement of posterior and lateral canals.