“Light cupula” involving all three semicircular canals: A frequently misdiagnosed disorder

Kim, Chang-Hee; Shin, Jung Eun; Shin, Dong Hyuk; Kim, Yongwon; Ban, Jae Ho

doi:10.1016/j.mehy.2014.09.002

Cited by 21 publications

(13 citation statements)

References 18 publications

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“…The attachment of light debris, as yet unidentified, to the cupula was suggested as a cause of light cupula, 6 whereas other reports propose an increase in the specific gravity of the endolymph as a cause. 4,7,18 Although vertical and torsional components can also occur, 19 horizontal nystagmus predominates in light cupula. Heavy cupula, thought to be caused by lighter endolymph, may be a part of the pathophysiology of persistent apogeotropic DCPN, although otolith particles attached to the cupula are the currently accepted mechanisms.…”

Section: Discussionmentioning

confidence: 99%

A new method for evaluating lateral semicircular canal cupulopathy

2015

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Section: Discussionmentioning

confidence: 99%

A new method for evaluating lateral semicircular canal cupulopathy

2015

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“…The attachment of light debris, which has not been identified yet, onto the cupula has been suggested as a cause of the light cupula [ 7 ], which was further supported by recent findings that the angle of the null plane was significantly greater in the light cupula than the heavy cupula assumably due to attachment of light debris onto the lateral side of the hSCC cupula in case of the light cupula [ 11 ]. An increase in the specific gravity of the endolymph was proposed as another mechanism of the light cupula by others [ 4 5 6 ], which was further supported by recent findings that a light cupula can be accompanied by SSNHL [ 3 ], and that vertical and torsional components of positional nystagmus can be observed possibly due to the involvement of light cupula phenomenon in all three semicircular canals on the same side [ 15 ]. It was speculated that increased protein content within the endolymph caused by an insult to the inner ear in patients with SSNHL may elevate the specific gravity of the endolymph, which consequently results in the condition of a light cupula [ 3 ].…”

Section: Discussionmentioning

confidence: 69%

Persistent Positional Vertigo in a Patient with Sudden Sensorineural Hearing Loss: A Case Report

et al. 2015

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Because inner ear organs are interconnected through the endolymph and surrounding endolymphatic membrane, the patients with sudden sensorineural hearing loss (SSNHL) often complain of vertigo. In this study, we report a patient with SSNHL accompanied by persistent positional vertigo, and serial findings of head-roll tests are described. At acute stage, head-roll test showed persistent geotropic direction-changing positional nystagmus (DCPN), which led to a diagnosis of SSNHL and ipsilateral light cupula. Although vertigo symptom gradually improved, positional vertigo lasted for more than 3 weeks. At this chronic stage, persistent apogeotropic DCPN was observed in a head roll test, which led to a diagnosis of the heavy cupula. Although the mechanism for the conversion of nystagmus direction from geotropic to apogeotropic persistent DCPN is unclear, the change of specific gravity of the endolymph might be one of the plausible hypothetical explanations.

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“…The attachment of light debris to the cupula has been suggested as a cause of light cupula [ 2 ], but the light debris has not been identified yet. Others have proposed that the increase in the specific gravity of the endolymph may contribute to light cupula [ 1 , 5 ], which was further supported by recent findings suggesting that light cupula can be accompanied by sudden sensorineural hearing loss ipsilaterally [ 6 ], and that the condition of light cupula may involve all 3 SCCs on the same side [ 7 ]. The most interesting finding of this case report is that the condition of light cupula occurred on both sides, of which the mechanism is still obscure.…”

Section: Discussionmentioning

confidence: 84%

Light cupula of the horizontal semicircular canal occurring alternately on both sides: a case report

Shin

Kim

2015

BMC Ear Nose Throat Disord

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BackgroundThe light cupula is a condition wherein the cupula of the semicircular canal has a lower specific gravity than its surrounding endolymph. It is characterized by a persistent geotropic direction-changing positional nystagmus in the supine head-roll test, and the identification of a null plane with slight head-turning to either side.Case presentationThis study describes a case of recurring light cupula that occurred alternately on both sides. At the first episode, a null plane was identified on the right side, which led to the diagnosis of a light cupula on the right side. At the second episode, a null plane was identified on the left side, leading to the diagnosis of a light cupula on the left side.ConclusionThis is the first case report of recurring light cupula alternately involving both sides. Although the pathophysiology is not entirely understood yet, the light cupula should be considered as one of causes of recurrent positional vertigo.Electronic supplementary materialThe online version of this article (doi:10.1186/s12901-015-0015-z) contains supplementary material, which is available to authorized users.

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“Light cupula” involving all three semicircular canals: A frequently misdiagnosed disorder

Cited by 21 publications

References 18 publications

A new method for evaluating lateral semicircular canal cupulopathy

A new method for evaluating lateral semicircular canal cupulopathy

Persistent Positional Vertigo in a Patient with Sudden Sensorineural Hearing Loss: A Case Report

Light cupula of the horizontal semicircular canal occurring alternately on both sides: a case report

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