KBB-Forum 2020 , Cilt 19, Sayı 4


Dr. Tuncay ÖZÇELİK1
1Bayındır Hastanesi KBB Kliniği, Ankara, Türkiye Benign paroxismal positionel vertigo is the most common disease that causes dizziness. In addition to standard definitions, cases where nystagmus is represented differently can be encountered. In similar situations that exhibit different behaviors of otoconia in the semicircular canal, the form of nystagmus should be evaluated well, and the form of nystagmus should be interpreted with the condition of otoconia.

Material Method: During the first 10 months of 2020, 687 of 1120 patients who were admitted with dizziness to the Bayindir Hospital ENT department were diagnosed as benign paroxismal positionel vertigo. The diagnosis in all cases was confirmed by Dix-Halpike and Roll tests that were screened by VNG. Patients with apogeotrophic torsional (clockwise-CW for right ear; counterclockwise-CCW for left ear) nystagmus were assigned as nonampullary short arm benign BPPV of the posterior semicircular canal. Semi-Semon and Forced Prolonged Position (FPP) maneuvers were applied for one minutes to these patients.

Findings: Five hundred twenty-one (521) of 687 (%75.8) patients who were diagnosed as benign paroxismal positionel vertigo in 10-month period. In 14 of these cases, the nystagmus was apogeotrophic and its torsional direction was opposite as compared with canalolithiasis. (clockwise-CW for right ear; counterclockwise-CCW for left ear). Boths sides were manifested equally. In 9 of 14 patients the nystagmus was disappeared whereas in 5 patients, treatment was continued with a 45 degrees forced extended position (FPP) maneuver.

Conclusion: Posterior semicircular canal short arm benign paroxismal positionel vertigo manifests itself with the development of nystagmus similar to anterior semicircular canal benign paroxismal positionel vertigo. Since the treatments are different from each other, the differential diagnosis of the two types of nystagmus should be made well. Keywords : Benign paroxismal positional vertigo, posterior semicircular canal, short leg, otoconia