Treatments of Lateral Semicircular Canal BPPV

Bae, Mi Ran; Moon, In Seok; Lee, Ju Hyoung; Kim, Hyun Jik; Lee, Won Sang

Abstract

BACKGROUND AND OBJECTIVES
Benign paroxysmal positional vertigo (BPPV) is a common vestibular disease. The theories of can-alolthiasis and cupulolithisis of posterior semicircular canal are commonly accepted in BPPV. Recently, not only posterior canal but also lateral canal BPPV were reported. The purposes of this study are to analyze the result of lateral canal BPPV treatment and to introduce effective schedule of reposition maneuvers and follow up. MATERIALS AND METHODS: Sixty two patients who were diagnosed as lateral semicircular canal BPPV were included in this study. Supine head turning test was done and eye movement was documented with videonystagmography. In the canalolithiasis type, barbecue rotation maneuver was performed and in the cupulolithiasis type, cupulolith reposition maneuver was performed. In each type of BPPV, we analyzed the number of treatment until nystagmus was disappeared, recurrence rate and relationship between recurrence and age, sex of patients. RESULTS: Canalolithiasis type was 55% and cupulolithiasis type was 37%. Eight percents of patients showed combined type. All except 2 cases (congenital malformation) were healed by the reposition maneuver. Vertigo recurred in about 30% of patients, and they were retreated with the reposition maneuver. There was no correlation between recurrence and age, sex of patients. CONCLUSION: In lateral semicircular canal BPPV, the reposition maneuver was a effective treatment method. The reposition maneuver was recommended to perform continuously once a day until nystagmus disappeared. Because recurrence rate was about 30%, continuous follow-up was needed.