Canal switch and re-entry phenomenon in benign paroxysmal positional vertigo: difference between immediate and delayed occurrence.
Identifieur interne : 000154 ( Main/Curation ); précédent : 000153; suivant : 000155Canal switch and re-entry phenomenon in benign paroxysmal positional vertigo: difference between immediate and delayed occurrence.
Auteurs : F. Dispenza [Italie] ; A. De Stefano [Italie] ; C. Costantino [Italie] ; D. Rando [Italie] ; M. Giglione [Italie] ; R. Stagno [Italie] ; E. Bennici [Italie]Source :
- Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale [ 1827-675X ] ; 2015.
Descripteurs français
- KwdFr :
- MESH :
- physiopathologie : Membrane des statoconies, Vertige positionnel paroxystique bénin.
- thérapie : Vertige positionnel paroxystique bénin.
- Adulte d'âge moyen, Facteurs temps, Femelle, Humains, Mâle, Études prospectives.
English descriptors
- KwdEn :
- MESH :
- physiopathology : Benign Paroxysmal Positional Vertigo, Otolithic Membrane.
- therapy : Benign Paroxysmal Positional Vertigo.
- Female, Humans, Male, Middle Aged, Prospective Studies, Time Factors.
Abstract
This prospective study was designed to evaluate the differences between immediate and delayed canal re-entry of otoliths after therapeutic manoeuvres in patients with benign paroxysmal positional vertigo (BPPV). A total of 196 patients with BPPV were visited and 127 matched our inclusion criteria. The mean age was 54.74 years. The horizontal semicircular canal (HSC) was involved in 30 cases and the posterior semicircular canal (PSC) in 97 patients. Patients with hearing loss in the ear affected by BPPV have a more recurrent form, compared to those with normal hearing. An immediate canal re-entry was recorded in 3 patients with HSC BPPV, all with geotropic nystagmus. In 7 patients with PSC BPPV, the immediate canal re-entry was detected and the delayed form was noted in 5 patients. The patients with the delayed canal re-entry underwent more than 2 previous manoeuvres. The canal re-entry was not related to the manoeuvre performed. The timing of the Dix-Hallpike test to verify the resolution of the BPPV had a significant role in immediate canal re-entry. A recurrence in the follow-up at least one month after treatment was recorded in 20 patients and was more frequent in patients that had canal re-entry. The canal re-entry or canal switch is a clinical entity that should be kept in mind of the neurotologist when approaching BPPV patients. It is important to distinguish it from recurrence when delayed and from manoeuvre failure when immediate. The timing of manoeuvre performing, in particular the final verification test after therapeutic sessions, is important to prevent the immediate reflux of particles into canals.
PubMed: 26019396
PubMed Central: PMC4443558
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pubmed:26019396Le document en format XML
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<term>Benign Paroxysmal Positional Vertigo (therapy)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Otolithic Membrane (physiopathology)</term>
<term>Prospective Studies (MeSH)</term>
<term>Time Factors (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term>
<term>Facteurs temps (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Membrane des statoconies (physiopathologie)</term>
<term>Mâle (MeSH)</term>
<term>Vertige positionnel paroxystique bénin (physiopathologie)</term>
<term>Vertige positionnel paroxystique bénin (thérapie)</term>
<term>Études prospectives (MeSH)</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Membrane des statoconies</term>
<term>Vertige positionnel paroxystique bénin</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Benign Paroxysmal Positional Vertigo</term>
<term>Otolithic Membrane</term>
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<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Benign Paroxysmal Positional Vertigo</term>
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<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Prospective Studies</term>
<term>Time Factors</term>
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<term>Facteurs temps</term>
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<front><div type="abstract" xml:lang="en">This prospective study was designed to evaluate the differences between immediate and delayed canal re-entry of otoliths after therapeutic manoeuvres in patients with benign paroxysmal positional vertigo (BPPV). A total of 196 patients with BPPV were visited and 127 matched our inclusion criteria. The mean age was 54.74 years. The horizontal semicircular canal (HSC) was involved in 30 cases and the posterior semicircular canal (PSC) in 97 patients. Patients with hearing loss in the ear affected by BPPV have a more recurrent form, compared to those with normal hearing. An immediate canal re-entry was recorded in 3 patients with HSC BPPV, all with geotropic nystagmus. In 7 patients with PSC BPPV, the immediate canal re-entry was detected and the delayed form was noted in 5 patients. The patients with the delayed canal re-entry underwent more than 2 previous manoeuvres. The canal re-entry was not related to the manoeuvre performed. The timing of the Dix-Hallpike test to verify the resolution of the BPPV had a significant role in immediate canal re-entry. A recurrence in the follow-up at least one month after treatment was recorded in 20 patients and was more frequent in patients that had canal re-entry. The canal re-entry or canal switch is a clinical entity that should be kept in mind of the neurotologist when approaching BPPV patients. It is important to distinguish it from recurrence when delayed and from manoeuvre failure when immediate. The timing of manoeuvre performing, in particular the final verification test after therapeutic sessions, is important to prevent the immediate reflux of particles into canals. </div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26019396</PMID>
<DateCompleted><Year>2017</Year>
<Month>04</Month>
<Day>05</Day>
</DateCompleted>
<DateRevised><Year>2018</Year>
<Month>11</Month>
<Day>13</Day>
</DateRevised>
<Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1827-675X</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>35</Volume>
<Issue>2</Issue>
<PubDate><Year>2015</Year>
<Month>Apr</Month>
</PubDate>
</JournalIssue>
<Title>Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale</Title>
<ISOAbbreviation>Acta Otorhinolaryngol Ital</ISOAbbreviation>
</Journal>
<ArticleTitle>Canal switch and re-entry phenomenon in benign paroxysmal positional vertigo: difference between immediate and delayed occurrence.</ArticleTitle>
<Pagination><MedlinePgn>116-20</MedlinePgn>
</Pagination>
<Abstract><AbstractText>This prospective study was designed to evaluate the differences between immediate and delayed canal re-entry of otoliths after therapeutic manoeuvres in patients with benign paroxysmal positional vertigo (BPPV). A total of 196 patients with BPPV were visited and 127 matched our inclusion criteria. The mean age was 54.74 years. The horizontal semicircular canal (HSC) was involved in 30 cases and the posterior semicircular canal (PSC) in 97 patients. Patients with hearing loss in the ear affected by BPPV have a more recurrent form, compared to those with normal hearing. An immediate canal re-entry was recorded in 3 patients with HSC BPPV, all with geotropic nystagmus. In 7 patients with PSC BPPV, the immediate canal re-entry was detected and the delayed form was noted in 5 patients. The patients with the delayed canal re-entry underwent more than 2 previous manoeuvres. The canal re-entry was not related to the manoeuvre performed. The timing of the Dix-Hallpike test to verify the resolution of the BPPV had a significant role in immediate canal re-entry. A recurrence in the follow-up at least one month after treatment was recorded in 20 patients and was more frequent in patients that had canal re-entry. The canal re-entry or canal switch is a clinical entity that should be kept in mind of the neurotologist when approaching BPPV patients. It is important to distinguish it from recurrence when delayed and from manoeuvre failure when immediate. The timing of manoeuvre performing, in particular the final verification test after therapeutic sessions, is important to prevent the immediate reflux of particles into canals. </AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Dispenza</LastName>
<ForeName>F</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>UOC Otorinolaringoiatria Ospedale "S. Giovanni di Dio" ASP 1, Agrigento, Italy;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>DE Stefano</LastName>
<ForeName>A</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Dipartimento di Audiologia e Riabilitazione Foniatrica, ASL Lecce, Italy;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Costantino</LastName>
<ForeName>C</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Istituto Igiene Università di Palermo, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rando</LastName>
<ForeName>D</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>UOC Otorinolaringoiatria Ospedale "S. Giovanni di Dio" ASP 1, Agrigento, Italy;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Giglione</LastName>
<ForeName>M</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>UOC Otorinolaringoiatria Ospedale "S. Giovanni di Dio" ASP 1, Agrigento, Italy;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Stagno</LastName>
<ForeName>R</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>UOC Otorinolaringoiatria Ospedale "S. Giovanni di Dio" ASP 1, Agrigento, Italy;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Bennici</LastName>
<ForeName>E</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>UOC Otorinolaringoiatria Ospedale "S. Giovanni di Dio" ASP 1, Agrigento, Italy;</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType>
<PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
</Article>
<MedlineJournalInfo><Country>Italy</Country>
<MedlineTA>Acta Otorhinolaryngol Ital</MedlineTA>
<NlmUniqueID>8213019</NlmUniqueID>
<ISSNLinking>0392-100X</ISSNLinking>
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<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D065635" MajorTopicYN="N">Benign Paroxysmal Positional Vertigo</DescriptorName>
<QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D010037" MajorTopicYN="N">Otolithic Membrane</DescriptorName>
<QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<OtherAbstract Type="Publisher" Language="ita"><AbstractText>Studio prospettico ideato per la valutazione delle differenze tra la conversione canalare o il rientro degli otoliti nei canali semicircolari successivo alle manovre terapeutiche nei pazienti affetti da VPPB. Sono stati valutati 196 pazienti affetti da VPPB, 127 dei quali corrispondevano ai criteri di inclusione. L'età media dei pazienti era di 54.74 anni. Il canale orizzontale è stato coinvolto in 30 casi e il canale posteriore in 97 pazienti. I pazienti con sordità neurosensoriale presentavano forme ricorrenti di VPPB, rispetto a quelli con udito normale. L'immediato rientro canalare è stato diagnosticato in 3 pazienti con VPPB del canale laterale, tutti con nistagmo geotropo. 7 pazienti con VPPB del canale posteriore hanno presentato un rientro canalare immediato e 5 la forma ritardata. I pazienti con rientro canalare ritardato avevano precedentemente subito più di 2 manovre di riposizionamento. Il rientro canalare non è risultato connesso al tipo di manovra eseguita. Il tempo di attesa tra l'esecuzione della manovra liberatoria e il test di verifica si è rivelato importante ai fini del rientro canalare immediato. La recidiva della BPPV dopo un mese dalle manovre liberatorie si è riscontrata in 20 pazienti ed è stata più frequente in quei pazienti che hanno avuto un fenomeno di rientro canalare. La conversione canalare ed il fenomeno del rientro canalare rappresentano delle entità cliniche che devono essere considerate dal medico che tratta le VPPB. Appare importante distinguere un rientro da un fallimento della manovra in caso di forme immediate, o da una recidiva di patologia in caso di forme ritardate. L'esecuzione del test di verifica del successo terapeutico dopo manovre di riposizionamento deve avere un distacco temporale sufficientemente ampio al fine di evitare il reflusso immediato di otoliti nei canali.</AbstractText>
</OtherAbstract>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Benign paroxysmal positional vertigo</Keyword>
<Keyword MajorTopicYN="Y">Canal conversion</Keyword>
<Keyword MajorTopicYN="Y">Dizziness</Keyword>
<Keyword MajorTopicYN="Y">Vertigo</Keyword>
<Keyword MajorTopicYN="Y">canal switch</Keyword>
</KeywordList>
</MedlineCitation>
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<Month>09</Month>
<Day>29</Day>
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<PubMedPubDate PubStatus="accepted"><Year>2015</Year>
<Month>03</Month>
<Day>08</Day>
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