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- Title
Anterior Canal Lithiasis: Diagnosis and Treatment.
- Authors
Casani, Augusto Pietro; Cerchiai, Niccolò; Dallan, Iacopo; Sellari-Franceschini, Stefano
- Abstract
Objective. To describe the clinical and oculographic features in patients with anterior semicircular canal benign paroxysmal positional vertigo and to determine the efficacy of a canalith repositioning procedure for its management.Study Design. Case series with chart review of patients presenting positional vertigo and positional downbeating nystagmus during a 2-year period.Setting. Outpatients’ tertiary referral center for balance disorders.Subjects and Methods. Eighteen patients suffering from positional vertigo and presenting positional downbeating nystagmus were treated with a maneuver based on a modification of the procedure proposed by Crevits. Mean outcome measure: disappearance of positional downbeating nystagmus.Results. Positional downbeating nystagmus was elicited unilaterally with the Dix-Hallpike maneuver in 6 cases. In 4 patients, it was triggered by both left and right Dix-Hallpike tests. In 8 patients, the positional nystagmus was elicited by a straight head-hanging maneuver. The positional nystagmus was purely downbeating in 12 patients. In the remaining, a torsional component was detected. After the treatment, only 1 patient showed positional nystagmus at 30 days.Conclusion. In anterior canal benign paroxysmal positional vertigo, the presence of a positional downbeating nystagmus in response to positional tests is key for diagnosis. In a significant number of patients, the affected side may not be detected because of the inconstant presence of a torsional component. Treatment with a simplified maneuver based on Crevits’s technique can be considered an effective method for the treatment of anterior canal lithiasis, especially when the affected side cannot be detected clearly.
- Subjects
SEMICIRCULAR canals; NYSTAGMUS; POSTURAL balance; VERTIGO treatment; OTOLITHS; OPERATIVE surgery; HEALTH outcome assessment; TREATMENT of ear diseases
- Publication
Otolaryngology-Head & Neck Surgery, 2011, Vol 144, Issue 3, p412
- ISSN
0194-5998
- Publication type
Article
- DOI
10.1177/0194599810393879