Gans repositioning maneuver

Gans repositioning maneuver positioning sequence is shown for hypothetical right posterior canal benign paroxysmal positional vertigo. (A) Patient is in primary position seated and facing forward. Position 1: Head turned 45° to left and placed in a side-lying position on right side. Otolith debris moves to center of posterior canal. (B) Position 2: Patient rolled from right side to left side with head maintained in position 45° to left. Otolith debris moves to common crus. (C) Liberatory headshake: After provocation of symptoms elicited by Position 2, patient instructed to shake head side-to-side three or four times. Otolith debris traverses common crus. (D) Position 3: Patient is returned to primary position. Body brought to seated position with head turned forward to center position. Otolith debris enters utricle.

Roberts R A, Gans R E, Montaudo R L. Efficacy of a new treatment maneuver for posterior canal benign paroxysmal positional vertigo[J]. Journal of the American Academy of Audiology, 2006, 17(8): 598-604.