Fig. 10.

Gufoni maneuver for treatment of apogeotropic benign paroxysmal positional vertigo involving the right horizontal semicircular canal (HC). From the sitting position (A), the patient lies onto the affected right side (B). In the sitting position, the otolithic debris are attached to the cupula or located in the anterior part of the right HC (A). Side-lying to the right side causes the particles to move toward the posterior part of the HC and this migration produces an ampullofugal endolymph flow and nystagmus beating away from the ground (B). In the side-lying position, the head is rotated toward the ceiling (C). With this head turning, the particles move further toward the posterior and fall into the utricle, causing an ampullofugal endolymph flow and nystagmus beating to the healthy side due to inhibition of right HC (C). Finally, the patient resumes the upright position (D). Each position is maintained for 2 minutes.