Fig. 9.

Gufoni maneuver for the treatment of geotropic benign paroxysmal positional vertigo involving the right horizontal semicircular canal (HC). From the sitting position (A), the patient lies onto the healthy left side (B). In the sitting position, the otolithic debris are located in the dependent posterior arm of right HC (A). Side-lying to the healthy side causes the particles to move further toward the posterior part of the right HC (B) and this migration produces an ampullofugal endolymph flow and nystagmus beating to the ground due to inhibition of the right HC. In the side-lying position, the head is rotated toward the ground (C). With this positional change, the particles move further toward the posterior part and fall into the utricle, causing ampullofugal endolymph flow and nystagmus beating to the healthy left side (C). The patient is then returned to the upright position (D). Each position is maintained for 2 minutes.