Reversible Canalith Jam of the Horizontal Semicircular Canal Mimicking Cupulolithiasis

Ann Otol Rhinol Laryngol. 2021 Nov;130(11):1213-1219. doi: 10.1177/00034894211007245. Epub 2021 Apr 3.

Abstract

Objective: To describe a case of benign paroxysmal positional vertigo (BPPV) resulting in reversible horizontal semicircular canalith jam successfully treated with horizontal canal occlusion. A brief literature review of similar cases was performed.

Methods: Case report and literature review.

Results: A 68-year-old female presented with apogeotropic positional nystagmus, attributed to reversible horizontal canalith jam mimicking cupulolithiasis that was refractory to tailored repositioning maneuvers across months. She was unable to work due to the severity of her symptoms. She underwent surgical occlusion of the affected canal with immediate resolution of her symptoms. A literature review revealed similar cases of canalith jam mimicking cupulolithiasis.

Conclusions: Reversible canalith jam, in which particles moving with horizontal head position alternate between obstructing the semicircular canal and resting on the cupula, can mimic signs of cupulolithiasis. This variant of BPPV can be effectively managed with surgical canal occlusion should symptoms fail to resolve after tailored repositioning maneuvers.

Keywords: benign paroxysmal positional vertigo; canalith jam; cupulolithiasis; neurotology; otologic surgical procedures.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Benign Paroxysmal Positional Vertigo* / diagnosis
  • Benign Paroxysmal Positional Vertigo* / etiology
  • Benign Paroxysmal Positional Vertigo* / physiopathology
  • Benign Paroxysmal Positional Vertigo* / surgery
  • Diagnosis, Differential
  • Diagnostic Techniques, Otological
  • Female
  • Humans
  • Labyrinthitis* / diagnosis
  • Labyrinthitis* / physiopathology
  • Labyrinthitis* / surgery
  • Lithiasis / diagnosis
  • Otolithic Membrane* / pathology
  • Otolithic Membrane* / physiopathology
  • Otologic Surgical Procedures / methods
  • Semicircular Canals* / pathology
  • Semicircular Canals* / surgery
  • Treatment Outcome
  • Vestibular Diseases / diagnosis*