Clinical characteristics and associated factors of canal switch in benign paroxysmal positional vertigo

Lee, Geonho; Lee, Seulgi; Park, Hee-Sung; Kim, Bong Jik; Choi, Seo-Youn; Choi, Jin Woong

doi:10.3233/ves-190667

Cited by 14 publications

(11 citation statements)

References 20 publications

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“…In 14 cases this resulted in a geotropic h-BPPV, and in two cases it caused an apogeotropic h-BPPV. These outcomes are in line with data reported in previous studies ( 12 , 13 ). Since a canal conversion occurs from a re-entry of otolithic debris from the posterior canal into the horizontal canal via the utricle, it is reasonable to assume that the debris floats into the posterior part of the horizontal semicircular canal, which causes a geotropic h-BPPV rather than an apogeotropic h-BPPV ( 14 ).…”

Section: Discussionsupporting

confidence: 93%

“…The total resolution of both horizontal and posterior canal BPPV was slightly lower. This is because a substantial part of the patients developed a posterior canal BPPV after a resolution of horizontal canal BPPV which might be due to multiple canal involvement or canal switch from h-BPPV to p-BPPV ( 12 , 24 ).…”

Section: Discussionmentioning

confidence: 99%

“…Although h-BPPV often occurs spontaneously, it may also arise as a complication after treatment for p-BPPV as a result of canal conversion. This occurs in about 1 to 9% of those treated for p-BPPV with a canalith repositioning maneuver (12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

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Treatment Results of Geotropic and Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo in a Tertiary Dizziness Clinic

et al. 2021

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Purpose: To determine the effectiveness of our treatment protocol for geotropic and apogeotropic horizontal canal benign paroxysmal positional vertigo (h-BPPV).Methods: We retrospectively evaluated patients with newly diagnosed geotropic and apogeotropic h-BPPV who visited our clinic between July 2017 and December 2019. Patients were treated according to our treatment protocol, which was implemented in 2017. Patients with geotropic h-BPPV were preferably treated with the Gufoni maneuver. In patients with apogeotropic h-BPPV we executed the modified Gufoni maneuver to achieve conversion to the geotropic type. We looked at the number of successful treatments and the number of recurrences within 1 year.Results: We included 102 patients with h-BPPV, 62 (61%) of whom were treated for geotropic h-BPPV. The ratio of apogeotropic to geotropic h-BPPV was 0.65. After the first visit, we observed resolution of horizontal canal BPPV in 71 and 63% of the geotropic and the apogeotropic group, respectively. After the second visit, this percentage increased to 92% for geotropic h-BPPV and 78% for apogeotropic h-BPPV. After 1 year of follow-up we determined a recurrence rate of 32 and 24% for the geotropic and apogeotropic group, respectively.Conclusion: With our treatment protocol we managed to achieve high rates of symptom resolution in the geotropic and apogeotropic type of h-BPPV with acceptable recurrence rates. We observed a relatively high ratio of apogeotropic h-BPPV to geotropic h-BPPV.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Treatment Results of Geotropic and Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo in a Tertiary Dizziness Clinic

et al. 2021

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“…A canal switch can result from a repositioning maneuver itself or from a subsequent diagnostic positional test. The reported rates of canal conversion following treatment of PC-BPPV with the EM range from 2.4% ( Lee et al., 2019 ) to 16% ( Foster et al., 2012 ). Re-entrance of the otoliths during a diagnostic maneuver (such as the Dix-Hallpike) is also possible, when the otoliths drop back into the same (previously cleared) canal ( Dispenza et al., 2015 ; Foster et al., 2012 ).…”

Section: Introductionmentioning

confidence: 99%

“…Re-entrance of the otoliths during a diagnostic maneuver (such as the Dix-Hallpike) is also possible, when the otoliths drop back into the same (previously cleared) canal ( Dispenza et al., 2015 ; Foster et al., 2012 ). The former complications are usually poorly tolerated by the patient and the risk logically increases in proportion to the number of EMs performed ( Lee et al., 2019 ).…”

Section: Introductionmentioning

confidence: 99%

A comparative study of two methods for treatment of benign paroxysmal positional vertigo in the emergency department

et al. 2021

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Introduction Posterior canal benign paroxysmal positional vertigo (PC-BPPV) is considered the most common cause of peripheral vertigo in the emergency department (ED). Although the canalith repositioning maneuver (CRM) is the standard of care, the most effective method to deliver it in the ED has been poorly studied. Objective To compare two protocols of the Epley maneuver for the treatment of PC-BPPV. Patients and methods We prospectively recruited 101 patients with unilateral PC-BPPV on physical examination, randomizing them to either a single Epley maneuver (EM) (n = 46) or multiple maneuvers (n = 55) on the same visit. Measured outcomes included presence/absence of positional nystagmus, resolution of vertigo, and score on the dizziness handicap inventory (DHI) at follow-up evaluations. The DHI was stratified into mild (≤30) and moderate-severe (>30). Results Normalization of the Dix-Hallpike maneuver at day 5 was observed in 38% of the single EM group and 44.4% in the multiple EM group (p = 0.62). The DHI showed reduction from 42.2 (SD 18.4) to 31.9 (SD 23.7) in the single EM group and from 43.7 (SD 22.9) to 33.5 (SD 21.5) in the multiple EM group (p = 0.06). A higher number of patients improved from moderate-severe to mild DHI (p = 0.03) in the single EM group compared to the multi-EM group (p = 0.23). Conclusion There was no statistically significant difference between performing a single EM versus multiple EMs for treatment of PC-BPPV in the emergency department. The single EM approach is associated with shorter physical contact between patients and examiner, which is logically safer in a pandemic context.

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Benigner peripherer paroxysmaler Lagerungsschwindel

Thömke¹

2021

HNO

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Clinical characteristics and associated factors of canal switch in benign paroxysmal positional vertigo

Cited by 14 publications

References 20 publications

Treatment Results of Geotropic and Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo in a Tertiary Dizziness Clinic

Treatment Results of Geotropic and Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo in a Tertiary Dizziness Clinic

A comparative study of two methods for treatment of benign paroxysmal positional vertigo in the emergency department

Benigner peripherer paroxysmaler Lagerungsschwindel

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