Apogeotropic variant of horizontal semicircular canal benign paroxysmal positional vertigo: Where are the particles?

  • Bernardo Faria Ramos | bernardoframos@gmail.com Department of Otorhinolaryngology, Espirito Santo Federal University, Vitória, Brazil.
  • Renato Cal Department of Otorhinolaryngology, Parà Federal University, Belém, Brazil.
  • Camila Martins Brock Department of Otorhinolaryngology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
  • Pedro Luiz Mangabeira Albernaz Federal University of São Paulo, São Paulo, Brazil.
  • Francisco Zuma e Maia Department of Otorhinolaryngology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.

Abstract

The apogeotropic variant of horizontal semicircular canal benign paroxysmal positional vertigo (HC-BPPV) is attributed to free floating particles in the anterior arm of the lateral semicircular canal – particles attached to the cupula facing the canal or particles attached to the cupula facing the utricle. Zuma e Maia described a new treatment for both canalithiasis of the anterior arm of the horizontal semicircular canal (HC) and cupulolithiasis of the HC. Seventeen patients with apogeotropic HC-BPPV were enrolled and treated with Zuma’s Maneuver. During the repositioning of the particles to the utricule, we observed the direction of the nystagmus evoked in each step of this maneuver in order to know where the otoliths were probably located. Eight patients were diagnosed with canalithiasis of the anterior arm, six patients with cupulolithiasis with the particles facing the canal and three patients with cupulolithiasis with the particles facing the utricle. Our data suggest that we can assume where the otoliths are probably located by observing the pattern of the nystagmus evoked in each step of the Zuma’s Maneuver in patients with apogeotropic HC-BPPV.

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Published
2019-08-29
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Original Articles
Keywords:
Apogeotropic horizontal canal benign paroxysmal positional vertigo, Vertigo, Repositioning maneuver
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How to Cite
Ramos, B. F., Cal, R., Brock, C. M., Mangabeira Albernaz, P. L., & Zuma e Maia, F. (2019). Apogeotropic variant of horizontal semicircular canal benign paroxysmal positional vertigo: Where are the particles?. Audiology Research, 9(2). https://doi.org/10.4081/audiores.2019.228