All the BPPV variants shared the same clinical and demographic characteristics and responded equally well to treatment. However, differential diagnosis was necessary to apply the appropriate canalith repositioning procedure. Although data from clinical and histologic studies do not fully account for the observed relative occurrence of each variant of BPPV, a satisfactory explanation may be provided by the anatomic location of each semicircular canal and additionally by self-treatment of most cases of the horizontal and the anterior canal variety.

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Benign paroxysmal positional vertigo (BPPV) is a common peripheral vestibular disorder encountered in primary care and specialist otolaryngology and neurology clinics. It is associated with a characteristic paroxysmal positional nystagmus, which can be elicited with specific diagnostic positional maneuvers, such as the Dix-Hallpike test and the supine roll test. Current clinical research focused on diagnosing and treating various types of BPPV, according to the semicircular canal involved and according to the implicated pathogenetic mechanism. Cases of multiple-canal BPPV have been specifically investigated because until recently these were resistant to treatment with standard canalith repositioning procedures. Probably, the most significant factor in diagnosis of the type of BPPV is observation of the provoked nystagmus, during the diagnostic positional maneuvers. We describe in detail the various types of nystagmus, according to the canals involved, which are the keypoint to accurate diagnosis.

Background. Lingual abscesses are very rare, and as a result, the individual surgeon usually lacks experience in the diagnosis and therapy of this entity. We present four cases of abscesses of the tongue diagnosed and treated during the past 2 years.Methods. The medical records, films, and charts of four patients with lingual abscess were retrospectively reviewed. The clinical presentation, radiographic features, treatment, and outcome of the cases were examined.Results. Diagnosis was obtained by clinical examination and CT. In all cases, we avoided incision and drainage and preferred draining the abscess and aspirating pus with a large-bore needle through the inferior surface of the tongue. All patients responded remarkably well and did not have any recurrence.Conclusions. Lingual abscesses are rare conditions. In contrast to the approach in cases of most deep neck space infections, a more conservative therapeutic approach by needleaspiration is effective and has the advantages of not exacerbating the edema of the tongue and of avoiding airway compromise. A

Benign tumors of the tonsils occur infrequently. Lymphangiomas are rare congenital tumors of the lymphatic system, and tonsillar lymphangioma is an extremely rare occurrence. Its pathogenesis is uncertain, but history, clinical examination, and histological examination should establish the diagnosis. We present a 17-year-old white male with lymphangioma of the right tonsil. The tonsils were excised and biopsy confirmed the diagnosis. Tonsillar lymphangioma is a rare clinical entity, which should be known to the otolaryngologist, in order to diagnose and treat it appropriately and avoid confusion with tonsillar malignancies.