Horizontal semicircular canal jam: Two new cases and possible mechanisms

Laryngoscope Investigative Otolaryngology
Michael C SchubertVincenzo Marcelli

Abstract

Benign paroxysmal positional vertigo (BPPV) of the horizontal semicircular canal (hSCC) can present with otoconia blocking its lumen (canalith jam), with signs and symptoms that make it difficult to distinguish from central nervous system pathology. Here we report two cases of canalith jam affecting the hSCC and offer a theoretical mechanism based on known vestibular neurophysiology. We use video-oculography to document the canalith jam and show the moment the otoconia loosen. Canalith jam is a rare form of BPPV remedied with repositioning maneuvers. Clinicians should consider canalith jam as a mechanism for BPPV when the nystagmus is (a) Direction fixed with fixation removed and during positional testing; (b) Velocity dependent on supine head position; (c) Converts to geotropic directional changing nystagmus.

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Citations

Jun 27, 2020·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Dario A YacovinoEstefania Zanotti
Sep 15, 2020·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Dario A YacovinoEstefania Zanotti
Dec 5, 2020·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Andrea CastellucciAngelo Ghidini
Mar 23, 2021·Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale·Luigi CalifanoMaria Grazia Melillo

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