Message: https://link.springer.com/article/10.1007/s12070-019-01737-4#:~:text=BPPV%20originating%20from%20stimulation%20of,lateral%20canal%20instead%20of%20the Lateral Semicircular Canal BPPV…Are We Still Ignorant? Jaskaran Singh & Bhanu Bhardwaj Indian Journal of Otolaryngology and Head & Neck Surgery volume 72, pages175–183(2020)Cite this article 137 Accesses Metricsdetails Abstract Benign Paroxysmal Vertigo is one of the most common causes of vertigo. The most common semicircular canal involved in pathogenesis of BPPV is Posterior semicircular canal. However anterior and lateral semicircular canals can also sometimes be responsible for BPPV but their involvement in pathogenesis is still underrated. The incidence of lateral semicircular canal BPPV is in literature is around 10–12% while anterior canal is about 3%. The main objective of this study was to provide the database for incidence of lateral canal BPPV from a tertiary care hospital with the aim that more clinicians incorporate this entity into their differential diagnosis when their cases of posterior canal BPPV are refractory. This was an observational cross-sectional study of 300 patients of BPPV who were coming in ENT OPD as primum or as referral. All the patients underwent both the Dix–Hallpike maneuver as well as the supine roll test. The patients who were having upbeating torsional vertical nyst agmus on Dix–Hallpike were treated on lines of posterior canal BPPV whereas those with horizontal nystagmus on supine roll test were treated on lines of lateral canal BPPV. The data was tabulated and analysed for the incidence of lateral canal BPPV. Out of 300 patients; 188 were males and 122 were females. Most commonly affected age group by BPPV was 40–50 years. Out of 300 cases 260 cases (86.6%) had posterior BPPV and 37 cases (12.3%) had lateral canal BPPV. 3 cases (1%) also had anterior canal BPPV. 30/37 cases of lateral BPPV had geotropic nystagmus while 7 cases had apo-geotropic nystagmus. Posterior canal BPPv was treated by Epleys maneuver. Superior canal BPPV was treated by Yacovino maneuver. The cases of lateral canal BPPV were treated by either Vannucchi-asprella; Gufoni; Lempert maneuver or by the combination of two maneuvers. Lateral canal BPPV is an important diagnosis to consider in all cases of BPPV. Its true incidence is still under blanket as many clinicians are not using supine roll test routinely in their practice while diagnosing BPPV. Many refractory cases of BPPV can be cured if the involvement of other canals in its pathogenesis is kept in the mind so that correct diagnostic and repositioning maneuvers can be applied. We also encourage more institutional studies on lateral canal BPPV so that a standard treatment protocol with clear indications can be designed for this entity as is available for BPPV. This is a preview of subscription content, access via your institution. References 1. Hotson JR, Baloh RW (1998) Acute vestibular syndrome. N Engl J Med 339:680–685 CAS Article Google Scholar 2. Bertholon P, Tringali S, Faye MB, Antoine JC, Martin C (2006) Prospective study of positional nystagmus in 100 consecutive patients. Ann Otol Rhinol Laryngol 115:587–594 Article Google Scholar 3. Barany R (1921) Diagnose von krankheitserscheinungen im. Bereiche des otolithenapparates. Acta Otolaryngol 2:434–437 Article Google Scholar 4. Dix MR, Hallpike CS (1952) The pathology symptomatology and diagnosis of certain common disorders of the vestibular system. Proc R Soc Med 45:341–354 CAS PubMed PubMed Central Google Scholar 5. Schuknecht HF (1969) Cupulolithiasis. Arch Otolaryngol 90:765–778 CAS Article Google Scholar 6. Parnes LS, McClure JA (1992) Free-floating endolymph particles: a new operative finding during posterior semicircular canal occlusion. Laryngoscope 102:988–992 CAS Article Google Scholar 7. McClure JA (1985) Horizontal canal BPV. J Otolaryngol 14:305 Google Scholar 8. Casani AP, Vannucci G, Fattori B, Berrettini S (2002) The treatment of horizontal canal positional vertigo: our experience in 66 cases. Laryngoscope 112:172–178 Article Google Scholar 9. Anagnostou E, Kouzi I, Spengos K (2015) Diagnosis and treatment of anterior-canal benign paroxysmal positional vertigo: a systematic review. J Clin Neurol 11(3):262–267 Article Google Scholar 10. Imai T, Takeda N, Ikezono T, Shigeno K, Asai M, Watanabe Y et al (2017) Classification, diagnostic criteria and management of benign paroxysmal positional vertigo. Auris Nasus Larynx 44:1–6 Article Google Scholar 11. Mandala M (2017) How to diagnose and treat BPPV. In: 3rd Congress of the European Academy of Neurology. Amsterdam 12. Dix MR, Hallpike CS (1952) The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Ann Otol Rhinol Laryngol 61(4):987–1016 CAS Article Google Scholar 13. Bhattacharyya N, Gubbels SP, Schwartz SR, Edlow JA, El-Kashlan H, Fife T, Holmberg JM, Mahoney K, Hollingsworth DB, Roberts R, Seidman MD, Prasaad Steiner RW, Tsai Do B, Voelker CC, Waguespack RW, Corrigan MD (2017) Clinical practice guideline: benign paroxysmal positional vertigo (update) executive summary. Otolaryngol Head Neck Surg 156(3):403–416 Article Google Scholar 14. Ranalli P (2019) An overview of central vertigo disorders. Adv Otorhinolaryngol 82:127–133 PubMed Google Scholar 15. Balatsouras DG, Koukoutsis G, Ganelis P, Korres GS, Kaberos A (2011) Diagnosis of single- or multiple-canal benign paroxysmal positional vertigo according to the type of nystagmus. Int J Otolaryngol 2011:483965. https://doi.org/10.1155/2011/483965 Article PubMed PubMed Central Google Scholar 16. Steddin S, Ing D, Brandt T (1996) Horizontal canal benign paroxysmal positioning vertigo (h-BPPV): transition of canalolithiasis to cupulolithiasis. Ann Neurol 40:918–922 CAS Article Google Scholar 17. Shin JE, Jeong KH, Ahn SH et al (2017) Change of nystagmus direction during a head-roll test in lateral semicircular canal cupulolithiasis. Auris Nasus Larynx 44:227–231 Article Google Scholar 18. Choung Y, Shin YR, Kahng H, Park K, Choi SJ (2006) 'Bow and lean test' to determine the affected ear of horizontal canal benign paroxysmal positional vertigo. Laryngoscope 116:1776–1781 Article Google Scholar 19. Lee JB, Han DH, Choi SJ, Park K, Park HY, Sohn IK, Choung Y (2010) Efficacy of the "bow and lean test" for the management of horizontal canal benign paroxysmal positional vertigo. Laryngoscope 120:2339–2346 Article Google Scholar 20. Korres SG, Balatsouras DG, Papouliakos S, Ferekidis E (2007) Benign paroxysmal positional vertigo and its management. Med Sci Monit 13(6):275–282 Google Scholar 21. Califano L, Salafia F, Mazzone S, Melillo MG, Califano M (2014) Anterior canal BPPV and apogeotropic posterior canal BPPV: two rare forms of vertical canalolithiasis. Acta Otorhinolaryngol Ital 34(3):189–197 CAS PubMed PubMed Central Google Scholar 22. Epley JM (1992) The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 107(3):399–404 CAS Article Google Scholar 23. Lempert T, Tiel-Wilck K, Positional A (1996) Maneuver for treatment of horizontal-canal benign positional vertigo. Laryngoscope 106(4):476–478 CAS Article Google Scholar 24. Asprella Libonati G (2005) Diagnostic and treatment strategy of lateral semicircular canal canalolithiasis. Acta Otorhinolaryngol Ital 25(5):277–283 Google Scholar 25. Gufoni M, Mastrosimone L, Di Nasso F (1998) Repositioning maneuver in benign paroxysmal vertigo of horizontal semicircular canal. Acta Otorhinolaryngol Ital 18(6):363–367 CAS PubMed Google Scholar 26. Casani AP, Vannucci G, Fattori B et al (2002) The treatment of horizontal canal positional vertigo: our experience in 66 cases. Laryngoscope 112:172–178 Article Google Scholar 27. Fife TD (1998) Recognition and management of horizontal canal benign paroxysmal positional vertigo. Am J Otol 19:345–351 CAS Article Google Scholar 28. Steenerson RL, Cronin GW, Marbach PM (2005) Effectiveness of treatment techniques in 923 cases of benign paroxysmal positional vertigo. Laryngoscope 115:226–231 Article Google Scholar 29. Honrubia V, Baloh RW, Harris MR et al (1999) Paroxysmal positional vertigo syndrome. Am J Otol 20:465–470 CAS PubMed Google Scholar 30. Macias JD, Lambert KM, Massingale S et al (2000) Variables affecting treatment in benign paroxysmal positional vertigo. Laryngoscope 110:1921–1924 CAS Article Google Scholar 31. Korres SG, Balatsouras DG (2004) Diagnostic, pathophysiologic, and therapeutic aspects of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 131:438–444 Article Google Scholar 32. Korres S, Balatsouras DG, Kaberos A, Economou C, Kandiloros D, Ferekidis E (2002) Occurrence of semicircular canal involvement in benign paroxysmal positional vertigo. Otol Neurotol 23(6):926–932 Article Google Scholar 33. Nuti D, Vannucchi P, Pagnini P (2005) Lateral canal BPPV: which is the affected side? Audiol Med 3(1):16–20 Article Google Scholar 34. Bertholon P, Faye MB, Tringali S et al (2002) Benign paroxysmal positional vertigo of the horizontal canal. Clinical features in 25 patients. Ann Otolaryngol Chir Cervicofac 119:73–80 CAS PubMed Google Scholar 35. Waespe W (1997) Benign positional vertigo and nystagmus of the horizontal semicircular canal. Schweiz Med Wochenschr 127:287–295 CAS PubMed Google Scholar 36. Vannucchi P, Pecci R (2011) About nystagmus transformation in a case of apogeotropic lateral semicircular canal benign paroxysmal positional vertigo. Int J Otolaryngol 2011:4. https://doi.org/10.1155/2011/687921 Article Google Scholar 37. Kurtzer DA, Gans RE, McLeod H (2017) New horizontal canal benign paroxysmal positional vertigo treatment: kurtzer hybrid maneuver. Glob J Otol 6(3):555686. https://doi.org/10.19080/GJO.2017.06.555686 Article Google Scholar 38. Bhattacharyya N, Gubbels SP, Schwartz SR, Edlow JA, El-Kashlan H, Fife T, Corrigan MD (2017) Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg 156(3):S1–S47 Article Google Scholar 39. Fife TD, Iverson DJ, Lempert T, Furman JM, Baloh RW, Tusa RJ et al (2008) Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 70:2067–2074 CAS Article Google Scholar 40. Nuti D, Mandalà M, Salerni L (2009) Lateral canal paroxysmal positional vertigo revisited. Ann NY Acad Sci 1164:316–323 Article Google Scholar 41. Tirelli G, Russolo M (2004) 360-Degree canalith repositioning procedure for the horizontal canal. Otolaryngol Head Neck Surg 131:740–746 Article Google Scholar 42. Chiou WY, Lee HL, Tsai SC, Yu TH, Lee XX (2005) A single therapy for all subtypes of horizontal canal positional vertigo. Laryngoscope 115:1432–1435 Article Google Scholar Download references Author information Affiliations Sri Guru Ram Das Institute of Health Sciences and Research, Amritsar, India Jaskaran Singh & Bhanu Bhardwaj Mohali, India Jaskaran Singh Amritsar, India Bhanu Bhardwaj Corresponding author Correspondence to Bhanu Bhardwaj. Ethics declarations Conflict of interest The authors declare that they have no conflict of interest. Ethical Approval Before starting the study Ethical Clearance was taken from the institutional ETHICAL Committee as per DECLARATION OF HELSINKI. Informed consent Informed consent was duly taken from all the patients. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Reprints and Permissions About this article Verify currency and authenticity via CrossMark Cite this article Singh, J., Bhardwaj, B. Lateral Semicircular Canal BPPV…Are We Still Ignorant?. Indian J Otolaryngol Head Neck Surg 72, 175–183 (2020). https://doi.org/10.1007/s12070-019-01737-4 Download citation Received 06 September 2019 Accepted 09 September 2019 Published 26 September 2019 Issue Date June 2020 DOI https://doi.org/10.1007/s12070-019-01737-4 Keywords Horizontal canal BPPV Lateral canal BPPV Geotropic nystagmus Apo-geotropic nystagmus Supine roll test Bow and bean test Vannucchi asprella maneuver Gufoni maneuver Lempert maneuver |
No comments:
Post a Comment