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European Archives of Oto-Rhino-Laryngology

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01-10-2016 | Otology

Lateralization of horizontal semicircular canal canalolithiasis and cupulopathy using bow and lean test and head-roll test

Authors: Chang-Hee Kim, Yong Gyu Kim, Jung Eun Shin, Young Soo Yang, Donghyuk Im

Published in: European Archives of Oto-Rhino-Laryngology | Issue 10/2016

Abstract

Accurate lateralization is important to improve treatment outcomes in horizontal semicircular canal (HSCC) benign paroxysmal positional vertigo (BPPV). To determine the involved side in HSCC-BPPV, the intensity of nystagmus has been compared in a head-roll test (HRT) and the direction of nystagmus was evaluated in a bow and lean test (BLT). The aim of this study is to compare the results of a BLT with those of a HRT for lateralization of HSCC-canalolithiasis and cupulopathy (heavy cupula and light cupula), and evaluate treatment outcomes in patients with HSCC-canalolithiasis. We conducted retrospective case reviews in 66 patients with HSCC-canalolithiasis and 63 patients with HSCC-cupulopathy. The affected side was identified as the direction of bowing nystagmus on BLT in 55 % (36 of 66) of patients with canalolithiasis, which was concordant with the HRT result in 67 % (24 of 36) of cases (concordant group). Lateralization was determined by comparison of nystagmus intensity during HRT in 30 patients who did not show bowing or leaning nystagmus. The remission rate after the first treatment was 71 % (17 of 24) in the concordant group and 45 % (5 of 11) in the discordant group. Both bowing and leaning nystagmus were observed in all patients with cupulopathy, and the side of the null plane was identified as the affected side. In conclusion, bowing and/or leaning nystagmus were observed in only 55 % of patients with HSCC-canalolithiasis, and the first treatment based on the result of BLT alone was effective in only 45 % of the patients in whom the BLT and HRT were discordant, which may suggest that the usefulness of BLT in lateralizing the HSCC-canalolithiasis may be limited.

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Title: Lateralization of horizontal semicircular canal canalolithiasis and cupulopathy using bow and lean test and head-roll test
Authors: Chang-Hee Kim
Yong Gyu Kim
Jung Eun Shin
Young Soo Yang
Donghyuk Im
Publication date: 01-10-2016
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 10/2016
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-016-3894-8

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Lateralization of horizontal semicircular canal canalolithiasis and cupulopathy using bow and lean test and head-roll test

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