Experimental study on the aetiology of benign paroxysmal positional vertigo due to canalolithiasis: comparison between normal and vestibular dysfunction models

Otsuka, Koji; Negishi, Miho; Suzuki, Mamoru; Inagaki, Taro; Yatomi, Masanori; Konomi, Ujimoto; Kondo, Takahito; Ogawa, Y

doi:10.1017/s0022215113003381

Cited by 6 publications

(3 citation statements)

References 24 publications

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“…11 The cupula is the gel-like structure in the ampulla of each semicircular canal that transduces mechanical endolymph flow into electrochemical nerve signals allowing the central nervous system to sense acceleration in the plane of that canal. This mechanism is supported by the response to canalith repositioning maneuvers, animal models, 12,13 abnormal utricular function in BPPV as determined by ocular vestibular evoked myogenic potential studies, 14 and a mathematical analysis. 15 The calcium carbonate material seems to originate from the otoconia of the macule of the utricle.…”

Section: Epidemiologymentioning

confidence: 93%

Benign Paroxysmal Positional Vertigo in the Acute Care Setting

Fife¹,

Brevern²

2015

Neurologic Clinics

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Section: Epidemiologymentioning

confidence: 93%

Benign Paroxysmal Positional Vertigo in the Acute Care Setting

Fife¹,

Brevern²

2015

Neurologic Clinics

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“…In general, the repositioning maneuver for HSCC cupulolithiasis relies on mechanisms such as mastoid oscillation, gravity, and inertia (rapid acceleration or deceleration) to detach the otolith debris from the cupula and move it into the utricle. However, there may be a controversy that mastoid vibration can rather induce the unintentional detachment of the intact otoconia from the utricular macula [ 12 , 13 , 14 , 15 ], and hopping exercises may be difficult for elderly patients with limited physical activity or patients with severe symptoms.…”

Section: Introductionmentioning

confidence: 99%

New Therapeutic Maneuver for Horizontal Semicircular Canal Cupulolithiasis: A Prospective Randomized Trial

Lee

Park

Kim

et al. 2022

JCM

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Background: There are debates on whether mastoid oscillation has any benefit or harm in treating horizontal semicircular canal (HSCC) cupulolithiasis. The goal of this study was to investigate the therapeutic effects of the new maneuver using only inertia and gravity and compare it with the previously reported cupulolith repositioning maneuver using mastoid vibration (CuRM). Methods: We enrolled 57 patients diagnosed with HSCC cupulolithiasis. Patients were randomly allocated to the previously reported CuRM or the new maneuver (briefly, 30° head rotation to the affected side and thereafter bidirectional side-lying) using simply inertia and gravity, and their immediate and short-term effects were evaluated. Results: The immediate success rate did not differ significantly between the CuRM (8 of 22, 36.4%) and the new maneuver (10 of 35, 28.6%) groups (p = 0.538, Pearson’s chi-square test). The late resolution rates at the first follow-up of the CuRM (75%, 9 of 12) and new maneuver groups (82.6%, 19 of 23) were very high, and there was no statistical difference between them (p = 0.670, Fisher’s exact test). Conclusions: This study showed that the new maneuver was effective for treating HSCC cupulolithiasis with an immediate success rate of 28.6% (10 of 35). Although it did not show better results than the existing maneuver using vibration, there was no statistical difference. Considering the debate on the effectiveness of oscillation, we believe our new maneuver is a conservative alternative that uses only inertia and gravity, and it can be easily performed in clinics where oscillation equipment is not available.

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“…Vibratory impacts and jumps were therefore proposed to induce the vertigo symptoms through displacement and/or dislocation of utricle otoconia that stimulate erroneously the angular accelerometers of the inner ear during the head's movements [inner ear cupulolithiasis or canalolithiasis hypotheses (Parnes & McClure, 1992; Schuknecht, 1969)]. Indeed, Otsuka et al (2014) showed in an animal model that vibrations at 500 Hz during 7 min and 36 s induced otoconial dislodgement. Vibert et al (2007) concluded that mountain biking, and especially downhill mountain biking (DMB), was a possible cause of post‐traumatic vertigo without head trauma.…”

Section: Introductionmentioning

confidence: 99%

Vertigo in downhill mountain biking and road cycling

Lion

Vibert

Bosser

et al. 2014

European Journal of Sport Science

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Vertigo has been described after the practice of mountain bike. This study aimed to investigate the prevalence of vertigo following competitions or training sessions of downhill mountain biking (DMB) or road cycling (RC). One hundred and two DMB riders, 79 road cyclists and 73 control participants filled in a survey intended to evaluate the prevalence of vertigo in daily living activities and following competitions or training sessions. Vertigo causal factors (crashes, head trauma, fatigue, characteristics of the path/road ridden) were recorded. DMB riders and road cyclists did not report more vertigo during daily living activities than controls. But DMB riders older than 30 had more risk to report vertigo than age-matched road cyclists (OR: 5.06, 95% CI: 1.23-20.62). Road cyclists aged between 20 and 29 were 2.59-fold (95% CI: 1.06-6.27) more likely to report vertigo than controls. After competitions and training sessions, DMB riders were 2.33-fold (95% CI: 1.22-4.41) more likely to report vertigo than road cyclists. Vertigo causal factors were crash with head trauma in DMB riders and fatigue in road cyclists. Vertigo during daily living activities may be of concern for cyclists, particularly older DMB riders. The accumulation of impacts (crashes, vibrations) during the career of a DMB rider may generate micro-traumatisms of the central nervous system and/or peripheral vestibular structures, particularly the otolith organs. In RC, the pathophysiological mechanisms generating vertigo might be effort-related disturbance of homeostasis. To avoid injuries, DMB riders should be aware that vertigo may occur at the end of training sessions or competitions.

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Experimental study on the aetiology of benign paroxysmal positional vertigo due to canalolithiasis: comparison between normal and vestibular dysfunction models

Abstract: The otoconia of the utricle were dislodged into the semicircular canal after applying vibration. The time to dislodgement was significantly shorter in the vestibular dysfunction models than in the normal models; the utricular macula sustained significant morphological damage.

Cited by 6 publications

References 24 publications

Benign Paroxysmal Positional Vertigo in the Acute Care Setting

Benign Paroxysmal Positional Vertigo in the Acute Care Setting

New Therapeutic Maneuver for Horizontal Semicircular Canal Cupulolithiasis: A Prospective Randomized Trial

Vertigo in downhill mountain biking and road cycling

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