[Analysis of the dysfunction frequency and characteristics of semicircular canal in benign paroxysmal positional vertigo]

Tai-sheng Chen, Shan-shan Li, Hong Dong, Peng Lin, Chao Wen, Yan Cheng, Hui Zhao, Yuan-xu Ma
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2012, 47 (10): 793-8

OBJECTIVE: To assess the characteristics of the dysfunction of semicircular canal in benign paroxysmal positional vertigo and the relationship with the ectopic otoconia.

METHODS: There were 214 patients with benign paroxysmal positional vertigo (BPPV), including 107 cases of posterior semicircular canal canalithasis (PSC-Can) 80 cases of horizontal semicircular canal canalithasis (HSC-Can), 27 cases of horizontal semicircular canal cupulolithiasis (HSC-Cup). One hundred and ninety (88.8%) patients were accompany with relevant diseases while 24 (11.2%) cases were not. They accepted low, middle and high frequency vestibular function tests, including caloric test (CT), head shaking test (HST) and video head impulse test (vHIT) respectively. The parameters of the unilateral weakness (UW), head shaking nystagmus (HSN) and video head impulse test gain (vHIT-G) were observed. Patients classified into three groups (PSC-Can, HSC-Can, HSC-Cup) according to the involvement semicircular canal. The results of the three tests were analyzed with SPSS16.0 software.

RESULTS: The positive cases of the three tests were vHIT: 15 (7.0%), HST: 52 (24.3%), CT: 152 (71.0%), a statistically significant difference (P < 0.05) was found between the three tests. When compared the Caloric Test, HST and vHIT between the BPPV patients with and without relevant diseases, there were no significant differences (P > 0.05). The variance without statistical significance (P > 0.05) was showed between three tests' results in each groups, it was also showed that the variance between the three groups in each tests reached no statistical significance (P > 0.05). The test of affected side UW between PSC-Can, HSC-Can and HSC-Cup showed the variance without statistical significance (F = 0.970, P = 0.383).

CONCLUSIONS: The lesion of semicircular canals has the same etiological factors with the utricle pathological change in benign paroxysmal positional vertigo, and the dysfunction mostly happens in low frequency range of semicircular canal frequency band. The ectopic otoconia is not the main etiological factors for that. HST and vHIT of middle and high frequency can not be ultimately used for the screening test evaluating due to the semicircular canal function in BPPV.

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