Canalolithiasis of the superior semicircular canal: an anomaly in benign paroxysmal vertigo

Abstract

According to the canalolithiasis theory, benign paroxysmal vertigo (BPPV) is caused by gravity-dependent movements of otoconial debris that collects in the endolymph of the posterior semicircular canal. Other parts of the vestibular organ are rarely affected, and it is mainly the horizontal canal that is affected by this atypical form of BPPV. Canalolithiasis of the superior semicircular canal must be considered an anomaly because the superior semicircular canal is the highest point of the vestibular organ and debris normally cannot collect in this special location. Until now, BPPV of the superior canal has mainly been dealt with theoretically in the literature. The authors present three patients with canalolithiasis of the superior semicircular canal and offer direct proof of the condition using high-resolution 3D MRI.

New therapeutic maneuver for anterior canal benign paroxysmal positional vertigo

“…nodulus lesion) [21]. Using high-resolution 3D MRI, Schratzenstaller et al [22] found morphological abnormality at the top of the superior semicircular canal (generating a stop to free floating otoconia) in patients with AC-BPPV resistant to therapy, particularly in patients with previous ear surgery or ear disease.…”

Involvement of the Anterior Semicircular Canal in Posttraumatic Benign Paroxysmal Positioning Vertigo

“…As there is only one report on this form of posttraumatic BPPV in the literature to the best of our knowledge (19), these 2 cases are presented in greater detail here:…”

“…To the best of our knowledge, there has only been 1 report about posttraumatic combined AC/PC BPPV of the same labyrinth so far (19). The authors demonstrated ipsilateral posterior and AC ''filling defects'' using highresolution MRI in a patient with BPPV symptoms after head trauma.…”

“…The simultaneous involvement of different semicircular canals (unilateral or bilateral) after head trauma has been described in case reports (e.g., [17,19]). A recent retrospective study revealed an association between head trauma and multiple-canal BPPV (18).…”

“…So far, there is only limited information indicating that head trauma is a risk factor for AC (10) and multiple-canal BPPV (18). In particular, posttraumatic combined AC/PC BPPV of the same labyrinth has rarely been described in the literature (19).…”