Rehabilitative monitoring of utricular dysfunction: VOCR findings before and after Epley maneuver in BPPV patients.

Objective: This study aimed to objectively evaluate utricular dysfunction in patients with posterior canal benign paroxysmal positional vertigo (BPPV) using the video Ocular Counter-Roll (vOCR) test and to monitor functional changes following the Epley maneuver.

Methods: The study included 30 patients diagnosed with BPPV (19 with right posterior canal involvement, 11 with left) and 30 age- and sex-matched healthy controls. After diagnosis was confirmed by the Dix-Hallpike test, all patients underwent the static vOCR test twice: before the Epley maneuver and during the follow-up examination in which nystagmus and vertigo were no longer observed in the Dix-Hallpike test. Measurements were performed using the Interacoustics VisualEyes™ 525 system and video oculography goggles. Participants were tested at 30° lateral body tilt positions, and only static torsional eye movements were analyzed.

Results: Prior to treatment, vOCR values on the affected side were significantly lower compared to the unaffected side and the control group. After treatment, a marked improvement was observed in vOCR responses, and the differences between groups were no longer statistically significant. The mean vOCR value increased from 3.77° to 6.00°, and the asymmetry ratio decreased from 25.80 to 2.84%.

Conclusion: The vOCR test appears to be an effective, rapid, and non-invasive clinical tool for evaluating utricular dysfunction and monitoring treatment response in BPPV patients. Its ability to provide objective data makes it a valuable complementary component in vestibular assessment protocols.