Originally conceived as a treatment for posterior cupulolithiasis, the Liberatory maneuver works for posterior canalithiasis. Although not intuitive, it is sometimes easier to treat large patients with the Liberatory maneuver than with Canalith Repositioning. This is the only maneuver in the treatment of BPPV that needs to be done rather quickly to be effective. If the transfer is too slow the canaliths will fall back, rather than forward and over to the common crus. The Liberatory maneuver is only effective when the head is hung well below horizontal at both the beginning and the end of the transfer.
This simulation was created using a BPPV model created by Michael Teixido MD and colleagues from human histology. An organized presentation of videos that illustrate distinctions important to the diagnosis and treatment of BPPV can be seen at BPPVViewer.com.
