Can the bending forward test be used to detect a diseased anterior semi-circular canal in patients with chronic vestibular multi-canalicular canalithiasis (BPPV)?

A novel maneuver for diagnosis and treatment of torsional-vertical down beating positioning nystagmus: anterior canal and apogeotropic posterior canal BPPV

“… 9 Since the PC is the most stimulated and assessed in the DH test, it is relevant to assume that the AC is better stimulated and assessed during a bending forward movement. 18 The Yacovino-Hain maneuver works symmetrically for unilateral AC-BPPV, regardless of which side is affected. 9 If we do not take into account the affected ear, TVP-DBNy can be triggered by loose otoconia in four semicircular canals: both ACs (AC-BPPV) and both PCs (APC-BPPV).…”

“…The bend forward test has been recently described as a diagnostic tool in the assessment of AC-BPPV by Iglebekk et al 18 The same group described a maneuver called “forward somersault” maneuver, 20 in which the patient is turned 360° forwardly. Similarly, to the Yacovino-Hain maneuver it works for both sides, but it does not take into account a possible APC-BPPV Additionally it requires a specialized movable chair and is therefore unlikely to be very clinically practical.…”

“…1Ca). With this movement, the inner ear labyrinth will be at a 90° forward bending; 18 if we add the 45° of head forward flexion Step I, the cupula of the AC will now be at 135° forward bending. 18 , 19 , 20 ( Fig.…”

“…With this movement, the inner ear labyrinth will be at a 90° forward bending; 18 if we add the 45° of head forward flexion Step I, the cupula of the AC will now be at 135° forward bending. 18 , 19 , 20 ( Fig. 2 ) In this position, loose otoconia in the AC will be displaced towards the lowest gravitational point of the canal, first using the inertia generated by the deceleration of the movement and then by gravity ( Fig.…”

Chronic Multicanalicular BPPV as a Possible Cause of mal de Débarquement Syndrome

“…To succeed with the treatment of a chronic mc-BPPV, a correct diagnosis is mandatory (3,15). Because of the possibility of a high endolymph density, the latency in the test positions can be more than 1 minute, even up to 5 minutes.…”