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Benign positional vertigo and endolymphatic hydrops: what is the connection?

Published online by Cambridge University Press:  20 June 2017

A F Jahn
A F Jahn*
Affiliation:
Department of Otolaryngology, Mount Sinai West Hospital, New York, USA
*
Address for correspondence: Dr A F Jahn, Department of Otolaryngology, Mt Sinai West Hospital, 1000 10th Ave, New York, NY 10019, USA E-mail: [email protected]
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Abstract

Background:

Although benign paroxysmal positional vertigo and endolymphatic hydrops are considered to be distinct diagnoses, a minority of vertiginous patients exhibit features of both conditions. This coincidence has been reported previously in the literature, and is reviewed here in terms of possible aetiology.

Results and conclusion:

A new hypothesis to account for both conditions is offered, implicating free-floating degenerating debris from the otolithic apparatus. It is postulated that the gelatinous/proteinaceous component may account for an osmotically induced hydrops, while the calcified fragments may induce positional vertigo.

Keywords

Endolymphatic HydropsBenign Positional Vertigo
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 8 , August 2017 , pp. 658 - 660
Copyright
Copyright © JLO (1984) Limited 2017 

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Footnotes

Presented at the 7th Asia Pacific Otology Neurotology Conference, 11–13 May 2016, Tehran, Iran.

References

1 Mizukoshi, K, Watanabe, Y, Shojaku, H, Okubo, J, Watanabe, I. Epidemiological studies on benign paroxysmal positional vertigo in Japan. Acta Otolaryngol Suppl 1988;447:67–72 Google Scholar
2 Gross, EM, Ress, BD, Viirre, ES, Nelson, JR, Harris, JP. Intractable benign positional vertigo in patients with Meniere's disease. Laryngoscope 2000;110:655–9CrossRefGoogle ScholarPubMed
3 Ernst, A, Basta, D, Seidl, R, Todt, I, Scherer, H, Clarke, A. Management of posttraumatic vertigo. Otolaryngol Head Neck Surg 2005;132:554–8CrossRefGoogle ScholarPubMed
4 Hoffer, ME, Gottshall, KR, Moore, R, Balough, BJ, Wester, D. Characterizing and treating dizziness after mild head trauma. Otol Neurotol 2004;25:135–8CrossRefGoogle ScholarPubMed
5 Gacek, RR. Evidence for a viral neuropathy in recurrent vertigo. ORL J Otorhinolaryngol Relat Spec 2008;70:6–14 CrossRefGoogle ScholarPubMed
6 Karlberg, M, Hall, K, Quickert, N, Hinson, J, Halmagyi, GM. What inner ear diseases cause benign paroxysmal positional vertigo? Acta Otolaryngol 2000;120:380–5Google Scholar
7 Schuknecht, H. Cupulolithiasis. Arch Otolaryngol 1969;90:765–78CrossRefGoogle ScholarPubMed
8 Moriarty, B, Rutka, J, Hawke, M. The incidence and distribution of cupular deposits in the labyrinth. Laryngoscope 1992;102:56–9CrossRefGoogle ScholarPubMed
9 Parnes, LS, McClure, JA. Free-floating endolymph particles: a new operative finding during posterior semicircular canal occlusion. Laryngoscope 1992;102:988–92CrossRefGoogle ScholarPubMed
10 Welling, DB, Parnes, LS, O'Brien, B, Bakaletz, LO, Brackmann, DE, Hinojosa, R. Particulate matter in the posterior semicircular canal. Laryngoscope 1997;107:90–4CrossRefGoogle ScholarPubMed
11 Kao, WT, Parnes, LS, Chole, RA. Otoconia and otolithic membrane fragments within the posterior semicircular canal in benign paroxysmal positional vertigo. Laryngoscope 2017;127:709–14CrossRefGoogle ScholarPubMed
12 Kveton, JF, Kashgarian, M. Particulate matter within the membranous labyrinth: pathologic or normal? Am J Otol 1994;15:173–6Google ScholarPubMed
13 Waltner, JG, Raymond, S. On the chemical composition of perilymph and endolymph. Laryngoscope 1950;60:912–18CrossRefGoogle ScholarPubMed
14 Morgenstern, C, Mori, N, Amano, H. Pathogenesis of experimental endolymphatic hydrops. Acta Otolaryngol Suppl 1984;406:56–8Google ScholarPubMed
15 Dohlman, GF. Experiments on fluid movements through the labyrinthine membranous walls. Int J Equilib Res 1973;3:20–6Google Scholar
16 Johnsson, LG, Hawkins, JE Jr, Rouse, RC, Linthicum, GH Jr. Cochlear and otoconial abnormalities in capsular otosclerosis with hydrops. Ann Otol Rhinol Laryngol Suppl 1982;97:3–15 Google Scholar
17 Phillips, JS, Prinsley, PR. A unified hypothesis for vestibular dysfunction? Otolaryngol Head Neck Surg 2009;140:477–9CrossRefGoogle ScholarPubMed