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Benign Paroxysmal Positional Vertigo.

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    Benign paroxysmal positional vertigo (BPPV) is caused by dislodged otoconia affecting inner ear mechanics. Effective treatments include particle repositioning maneuvers and surgical options for persistent cases.

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    Area of Science:

    • Otolaryngology
    • Neuroscience
    • Vestibular System

    Background:

    • Benign paroxysmal positional vertigo (BPPV) is a common inner ear disorder.
    • Understanding its pathophysiology is crucial for effective diagnosis and treatment.

    Purpose of the Study:

    • To review recent advancements in the pathophysiology, diagnosis, and treatment of BPPV.
    • To highlight the canalolithiasis model and contributing factors like calcium homeostasis.

    Main Methods:

    • Review of recent evidence supporting the canalolithiasis model.
    • Analysis of scanning electron micrographs of semicircular canal contents.
    • Evaluation of diagnostic utility of variant-specific provocative tests.
    • Assessment of efficacy for repositioning maneuvers and surgical interventions.

    Main Results:

    • The canalolithiasis model is supported as the primary mechanism and subtype of BPPV.
    • Free-floating otoconia of utricular origin were observed.
    • Calcium homeostasis influences otoconia dislodgement.
    • Specific tests enhance diagnostic yield, and treatments show efficacy.

    Conclusions:

    • BPPV results from altered inner ear mechanics due to dislodged otoconia.
    • Particle repositioning maneuvers are effective for most cases.
    • Surgical occlusion offers a solution for intractable BPPV.