“Comparison Between Epley and Gans Repositioning Maneuvers for Posterior Canal BPPV: A Randomized Controlled Trial”: Is Really “Gans” Repositioning Maneuver the Original One?

Dear Sir,

I read the paper “Comparison between Epley and Gans Repositioning Maneuvers for Posterior Canal BPPV. A Randomized Controlled Trial” by Dhiman Neetu et al.[1] published in Annals of Indian Academy of Neurology, April 6, 2023.

Once more again, I had to remark that changing the name to a maneuver does not make it new. With my Colleagues, I published in 2003 the article “Treatment of benign paroxysmal positional vertigo of posterior semicircular canal by ‘quick liberatory rotation maneuver’”,[2] in which we first described this approach.

Three years after, in 2006, Roberts et al. published their paper “Efficacy of a new treatment maneuver for posterior canal benign paroxysmal positional vertigo,”[3] using the name “hybrid maneuver,” then also called “Gans maneuver.” They did not quote our paper, so omitting to recognize our priority in describing the maneuever.

In 2003 we wrote: “We aimed to: (1) limit the rotation only to the head of the patient in the horizontal plane, while the trunk follows its movement, likewise in CRMs (Canalith Repositiong Maneuvers), so that efforts of both the patient and physician are limited; (2) perform this technique with a very important doctrinaire and practical difference: the movement is carried out very quickly (about 180°/s), so that our maneuver resembles the dynamics of MS (Semont maneuver).” We have called this maneuver, “Quick Liberatory Rotation.”

No doubt that our maneuver (2003!) and the “hybrid maneuver” (2006!) are based on the same principles and technique: it actually is a “fusion” between Semont and Epley maneuvers, as Dhiman Neetu, too, wrote: “(it) is a hybrid approach of Epley and Semont maneuvers.” No doubt that we were the first to publish it, but over these years, some authors forgot or ignored it.

Our paper, I remember to all of you, was in English, free-access, and indexed in Pub med: evidently, the authors did not carry out careful bibliographic research: the risk of plagiarism is always around the corner.

I would appreciate if the authors, now informed about our previous original paper, admit our priority in describing this maneuver.

PS: Finally, I am glad for this article: I thank the authors for demonstrating the effectiveness of our Quick Rotation Liberatory Maneuver, as indeed we too already did, of course.

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