The Barbecue Roll (Lempert) maneuver is used to reposition canalithiasis in which semicircular canal in BPPV?

• A. Horizontal canal in BPPV
• B. Posterior canal in BPPV
• C. Superior canal in BPPV
• D. Cochlear duct involvement

Answer: (A)

In BPPV, displaced otoconia travel within a semicircular canal and create abnormal endolymph flow during head movements. Treatment maneuvers are chosen to guide those debris particles out of the affected canal toward the utricle.

The Barbecue Roll (Lempert) maneuver is specifically designed for the horizontal canal. By rolling the patient through a full 360 degrees in the plane of the horizontal canal, gravity helps the debris travel along the canal and exit into the utricle. This orientation matches the horizontal canal’s geometry, making the debris movement efficient and effective.

Posterior canal BPPV is typically treated with maneuvers like the Epley or Semont, which are tailored to the vertical orientation of that canal. The superior canal is less commonly affected and requires different approaches. So the horizontal canal is the best target for this maneuver because its axis aligns with the rolling sequence and facilitates debris clearance along that canal.