Basophilic Deposits on the Cupula: Preliminary Findings Describing the Problems Involved in Studies Regarding the Incidence of Basophilic Deposits on the Cupula

High-Resolution Three-Dimensional Magnetic Resonance Imaging of the Vestibular Labyrinth in Patients with Atypical and Intractable Benign Positional Vertigo

“…In our own cases consisting of over 350 patients we found only 1 with a heavy cupula. Although the existence of cupular deposits seems to be a physiological process increasing with age [39,40] without causing positional vertigo, these findings are no evidence against the existence of a heavy cupula causing positional vertigo. In our opinion it is the quantity of debris attached to the cupula which is the decisive factor for the cupula becoming a gravity-sensitive organ causing positional vertigo.…”

“…Out of 292 patients with BPPV Honrubia et al [38] suspected involvement of the superior canal in only 4 cases (without being able to offer direct proof). In sections, the superior semicircular canal and its cupula showed a lower incidence of basophilic deposits compared to both posterior and lateral canals and cupula [39,40].…”

“…We propose the hypothesis that at least in a part of these patients an endothelium damage of the superior canal of the Ménière-affected side might have been responsible for the phenomenon of a 'bilateral' positional vertigo also on the 'contralateral' side. Another reason may be that usually patients try to avoid provocative head movements and therefore aggravate the disease, with a possible development also on the contralateral side, as free-floating debris in the vestibular labyrinth seems to be, to a certain extent, a physiological process [39,40].…”

Etiology of vertigo in children

“…Most of them were present in the cupulae of the lateral and posterior semicircular canal and less often on the cupula of the anterior canal. These data showed that cupular deposits are less frequently found in the pediatric labyrinth, because similar studies in adult temporal bones revealed that up to 35% of the examined cupulae contained basophilic deposits [28]. It appears, thus, that the presence of cupular deposits is probably a phenomenon of the aging labyrinth, which may explain the low incidence of BPPV in children.…”

Potential Cause of Positional Vertigo in Ménière's Disease

“…These findings are in line with a histopathologic report of human temporal bones by Kariya et al (9) that the contralateral ear in patients with unilateral Ménière's disease has significantly more damage as compared with normal controls. In addition, several studies that report symptom of bilateral BPPV in patients with Ménière's disease (10) Naganuma et al (11) reported that the incidence of cupular deposits increased with increasing age in human adult temporal bones. In our study, however, the incidence of cupular deposits in both bilateral and unilateral Ménière's disease was independent of aging, and there was a significant correlation between the incidence of cupular deposits and duration of disease in bilateral Ménière's disease.…”