Gans Repositioning Maneuver in Treating Posterior Canal Benign Paroxysmal Positional Vertigo: A Systematic Review

European Archives of Oto-Rhino-Laryngology

Alashram, A. R. (2026).

European Archives of Oto-Rhino-Laryngology, Advance online publication. https://doi.org/10.1007/s00405-026-10272-2.

<div>This systematic review compares the effects of the Gans repositioning maneuver to other maneuvers and positioning methods on symptoms in individuals with posterior canal benign paroxysmal positional vertigo (PC-BPPV).</div>

No funding received

From database inception to November 2025

<div>Randomized controlled trials (RCTs), clinical controlled trials (CCTs), or one-group pilot studies&nbsp;</div>

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<div> <div>The Gans repositioning maneuver demonstrates effects comparable to the Epley and Semont maneuvers for individuals with PC-BPPV. Specific findings by outcome measure include the following:</div> <div> <ul> <li><strong>Dix-Hallpike recovery rate ranges:</strong> Gans (46.7% to 98%), Epley (70% to 82%), and Semont (80% to 97%).</li> <li><strong>Visual Vertigo Analogue Scale (VVAS):</strong> Scores reduced from 65.13 to 25.35 with the Gans and from 64.00 to 33.48 with the Semont. Both the Gans and Epley maneuvers reduced symptoms 78-82%.</li> <li><strong>Dizziness Handicap Inventor (DHI):</strong> In one study, scores reduced from 44.96 to 17.74 with the Gans, and from 46.17 to 24.87 with the Semont. In another study, one-month follow-up scores decreased from 60.13 to 11.81 with the Gans and from 58.69 to 11.56 with the Epley. Near-complete relief of symptoms occurred in 98% of participants who underwent the Gans maneuver and in 95% of those who received the Epley.</li> <li><strong>Visual Analogue Scale (VAS):</strong> Improvement at one-month follow-up was 98% with the Gans and 95% with the Epley.</li> <li><strong>Vestibular Rehabilitation Benefit Questionnaire (VRBQ):</strong> Scores reduced from 72.55 to 12.81 with the Gans and from 73.41 to 14.31 with the Epley.</li> <li><strong>Recurrence rate ranges:&nbsp;</strong>0-10 with the Gans, 4-7 with the Semont, and 1-5 with the Epley.</li> </ul> </div> </div> <div>Limitations of this review include participant heterogeneity, inconsistent characteristic and data reporting, potential exclusion of relevant non-English studies, and lack of review registration. Additional high-quality research with less potential for bias is needed to investigate tolerability, quality of life, and long-term outcomes in individuals with PC-BPPV.</div>