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72 "Benign paroxysmal positional vertigo"
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Review
Canal Conversion and Reentry of Otolith in Benign Paroxysmal Positional Vertigo
Jong Sei Kim, Minbum Kim
Res Vestib Sci. 2023;22(3):59-67.   Published online September 15, 2023
DOI: https://doi.org/10.21790/rvs.2023.22.3.59
  • 1,118 View
  • 60 Download
AbstractAbstract PDF
During the treatment process for benign paroxysmal positional vertigo (BPPV) using the canalith repositioning procedure, the otolith can inadvertently enter the semicircular canal instead of the utricle. Canal conversion refers to the situation where the otolith enters a different semicircular canal, while reentry occurs when the otolith returns to the same semicircular canal. The occurrence of a canal conversion can complicate the accurate diagnosis and treatment of BPPV, potentially leading to misdiagnosis and unsuccessful results in the canalith repositioning procedure. In this review, we aim to summarize the incidence, clinical features, and associated risk factors of canal conversion and reentries.
Original Article
Clinical Characteristics of Benign Paroxysmal Positional Vertigo Positive on Bilateral Dix-Hallpike Test
Youngrok Jo, Gun Min Lee, Youn Jin Cho, Mi Joo Kim, Minbum Kim
Res Vestib Sci. 2023;22(1):14-18.   Published online March 13, 2023
DOI: https://doi.org/10.21790/rvs.2023.22.1.14
  • 2,229 View
  • 72 Download
AbstractAbstract PDF
Objectives
The purpose of this study is to investigate the clinical characteristics of benign paroxysmal positional vertigo (BPPV) which showed torsional nystagmus on bilateral Dix-Hallpike test, and to analyze the clinical features of pseudo-bilateral BPPV.
Methods
This study is a retrospective chart review of a total of 341 patients diagnosed with BPPV of posterior canal (PC-BPPV). Among them, patients who showed torsional nystagmus on bilateral Dix-Hallpike test were defined as “bilateral DixHallpike positive patients,” who were classified into true- and pseudo-bilateral PC-BPPV group through analysis of nystagmus direction. And pseudo-bilateral PC-BPPV were categorized into two subtypes according to their pathomechanisms. Clinical characteristics including sex, age, underlying vestibular disorders, recurrence and the number of Epley maneuvers were analyzed. Student t-test and Mann-Whitney U-test were used for statistical analysis.
Results
Among 341 patients, 27 patients (7.9%) were “bilateral Dix-Hallpike positive patients”. They received more Epley maneuvers than the group of unilateral PC-BPPV until the resolution of nystagmus (2.3 vs. 1.4, p<0.001). Fifteen patients out of 27 were diagnosed with pseudo-bilateral PC-BPPV, who were classified into two subtypes according to their pathomechanisms. The number of Epley maneuvers was not different between true- and pseudo-bilateral PC-BPPV.
Conclusions
Patients with pseudo-bilateral PC-BPPV were common among “bilateral Dix-Hallpike positive patients.” For their better treatment, understanding of possible pathophysiology, accurate Dix-Hallpike test and detailed analysis of nystagmus direction are necessary.
Review
Treatment in Benign Paroxysmal Positional Vertigo: Factors that Affect Successful Treatment Outcome
Dae Bo Shim
Res Vestib Sci. 2023;22(1):1-6.   Published online March 13, 2023
DOI: https://doi.org/10.21790/rvs.2023.22.1.1
  • 1,602 View
  • 69 Download
AbstractAbstract PDF
Benign paroxysmal positional vertigo (BPPV) is the most common etiology of benign vestibulopathy. Various treatments for BPPV have been developed, and appropriate treatments for each subtype of BPPV have been provided and used in accordance with clinical practice guidelines published by the American Academy of Otorhinolaryngology-Head and Neck Surgery in 2008 and 2017. Although many therapeutic maneuvers have been reported to show high success rates in the treatment of BPPV patients, some cases are not effective even by appropriate therapeutic maneuvers. This article reviews various factors affecting the successful treatment of BPPV patients.
Original Articles
The Head-Bending Test in Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo
Sol-lim Choi, Hyun-Sung Kim, Jae-Hwan Choi, Eun Hye Oh
Res Vestib Sci. 2022;21(4):99-103.   Published online December 15, 2022
DOI: https://doi.org/10.21790/rvs.2022.21.4.99
  • 2,082 View
  • 91 Download
AbstractAbstract PDF
Objectives
This study aimed to investigate clinical significance of a head-bending test in benign paroxysmal positional vertigo (BPPV) involving the posterior semicircular canal (PC-BPPV).
Methods
We retrospectively recruited 256 patients with unilateral PC-BPPV between January 2016 and December 2021, and assessed the clinical characteristics of patients showing head-bending nystagmus (HBN).
Results
Of 256 patients, 138 (53.9%) showed HBN. Most patients (n=136, 98.6%) had downbeat nystagmus with (n=38) or without (n=98) torsional component. The remaining two patients had pure upbeat and torsional nystagmus, respectively. The torsional component was directed to the contralesional side in all. Between patients with and without HBN, there were no significant differences in clinical characteristics such as age, lateralization, types of BPPV (canalolithiasis or cupulolithiasis), and success rate of repositioning maneuver.
Conclusions
Head-bending test may be useful in predicting the diagnosis and lateralization of PC-BPPV.
Development of An Algorithm for Slippage-Induced Motion Artifacts Reduction in Video-Nystagmography
Yerin Lee, Young Joon Seo, Sejung Yang
Res Vestib Sci. 2022;21(4):104-110.   Published online December 15, 2022
DOI: https://doi.org/10.21790/rvs.2022.21.4.104
  • 1,814 View
  • 58 Download
AbstractAbstract PDF
Objectives
The slippage of the video-nystagmography devices causes motion artifacts in the trajectory of the pupil and thus results in distortion in the nystagmus waveform. In this study, the moving average was proposed to reduce slippage-induced motion artifacts from the real-world data obtained in the field.
Methods
The dataset consists of an infrared video of positional tests performed on eight patients with a lateral semicircular canal benign paroxysmal positional vertigo. The trajectories of the pupil were obtained from the video with binarization, morphological operation, and elliptical fitting algorithm. The acquired data was observed and the section where the slippage occurred was labeled by an otolaryngologist. The moving average with windows of various lengths was calculated and subtracted from the original signal and evaluated to find the most adequate parameter to reduce the motion artifact.
Results
The period of nystagmus in the given data was found to be ranged from 0.01 to 4 seconds. The slippages that appeared in the data can be categorized into fast and slow slippages. The length, distance, and speed of trajectories in the slippage ranges were also measured to find the characteristics of the motion artifact in video-nystagmography data. The shape of the nystagmus waveform was preserved, and the motion artifacts were reduced in both types of slippages when the length of the window in moving average was set to 1 second.
Conclusions
The algorithm developed in this study is expected to minimize errors caused by slippage when developing a diagnostic algorithm that can assist clinicians.
Auto-Pattern Recognition for Diagnosis in Benign Paroxysmal Positional Vertigo Using Principal Component Analysis: A Preliminary Study
O-Hyeon Gwon, Tae Hoon Kong, Jaehong Key, Sejung Yang, Young Joon Seo
Res Vestib Sci. 2022;21(1):6-18.   Published online March 15, 2022
DOI: https://doi.org/10.21790/rvs.2022.21.1.6
  • 4,707 View
  • 83 Download
  • 1 Crossref
AbstractAbstract PDF
Objectives
The aim of this study was to develop a filtering algorithm for raw nystagmus images and a diagnostic assistive algorithm using a principal component analysis (PCA) to distinguish the different types of benign paroxysmal positional vertigo (BPPV).
Methods
Fifteen video clips of clinical data with typical nystagmus patterns of BPPV (13 cases) and with normal nystamgmus (two cases) were preprocessed when applied the thresholding, morphology operation, residual noise filtering, and center point extraction stages. We analyzed multiple data clusters in a single frame via a PCA; in addition, we statistically analyzed the horizontal and vertical components of the main vector among the multiple data clusters in the canalolithiasis of the lateral semicircular canal (LSCC) and the posterior semicircular canal (PSCC).
Results
We obtained a clear imaginary pupil and data on the fast phases and slow phases after preprocessing the images. For a normal patient, a round shape of clustered dots was observed. Patients with LSCC showed an elongated horizontal shape, whereas patients with PSCC showed an oval shape at the (x, y) coordinates. The scalar values (mm) of the horizontal component of the main vector when performing a PCA between the LSCC- and PSCC-BPPV were substantially different (102.08±20.11 vs. 32.36±12.52 mm, respectively; p=0.0012). Additionally, the salar ratio of horizontal to vertical components in LSCC and PSCC exhibited a significant difference (16.11±10.74 mm vs. 2.61±1.07 mm, respectively; p=0.0023).
Conclusions
The data of a white simulated imaginary pupil without any background noise can be a separate monitoring option, which can aid clinicians in determining the types of BPPV exhibited. Therefore, this analysis algorithm will provide assistive information for diagnosis of BPPV to clinicians.

Citations

Citations to this article as recorded by  
  • Development of An Algorithm for Slippage-Induced Motion Artifacts Reduction in Video-Nystagmography
    Yerin Lee, Young Joon Seo, Sejung Yang
    Research in Vestibular Science.2022; 21(4): 104.     CrossRef
Study on Platelet Indices in Benign Paroxysmal Positional Vertigo
Byeong Min Lee, Chae Dong Yim, Dong Gu Hur, Seong-Ki Ahn
Res Vestib Sci. 2021;20(4):141-146.   Published online December 15, 2021
DOI: https://doi.org/10.21790/rvs.2021.20.4.141
  • 2,949 View
  • 79 Download
AbstractAbstract PDF
Objectives
Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of dizziness. Even though the etiology of BPPV has been widely studied, the exact mechanism remains still unclear. One of the possible factors explaining the pathophysiology of BPPV is ischemia of vestibule. In the present study, we have focused on the platelet indices including mean platelet volume (MPV), platelet distribution width (PDW), and platelet crit (PCT) to assess a risk of vestibule ischemia causing BPPV.
Methods
From January 2021 to March 2021, a retrospective review was performed on 39 patients diagnosed with BPPV through vestibular nystagmography. For each platelet indices, a comparative analysis was conducted between the patient group and control group.
Results
There were no significant differences when the platelet, MPV, PDW, and PCT values were compared between the study and control group. Rather, the control group showed higher PDW value than the study group.
Conclusions
Ischemia of vestibule is one of the well-known causes of BPPV, but the current study showed that BPPV cannot be explained by the vestibule ischemia itself. Further studies are needed to identify the potential of ischemia regarding BPPV by approaching with other methods with a large study group.
Correlation between Residual Dizziness and Modified Clinical Test of Sensory Integration and Balance in Patients with Benign Paroxysmal Positional Vertigo
Jung-Yup Lee, In-Buhm Lee, Min-Beom Kim
Res Vestib Sci. 2021;20(3):93-100.   Published online September 15, 2021
DOI: https://doi.org/10.21790/rvs.2021.20.3.93
  • 4,955 View
  • 86 Download
  • 2 Crossref
AbstractAbstract PDF
Objectives
This study was performed to investigate the correlation between subjective residual dizziness and objective postural imbalance after successful canalith repositioning procedure (CRP) in benign paroxysmal positional vertigo (BPPV) by using questionnaires and modified Clinical Test of Sensory Integration and Balance (mCTSIB).
Methods
A total of 31 patients with BPPV were included prospectively in the study. All included patients were successfully treated after initial CRP and their symptoms and nystagmus disappeared. Two weeks after CRP, all patients were asked to fill out the questionnaire including both Dizziness Handicap Inventory (DHI) and visual analog scale (VAS). We also conducted mCTSIB 2 weeks after CRP. We divided patients into two groups according to VAS: RD (residual dizziness) group, VAS>0; non-RD group, VAS=0. We compared age, number of CRP, rates associated with three semicircular canals, DHI score and mCTSIB results between two groups. In addition, we analyzed the correlation between DHI score and mCTSIB results.
Results
There were no significant differences in age, number of CRP, and rates associated with three semicircular canals between the two groups. RD group showed significantly higher DHI score and abnormal mCTSIB results than the non-RD group (p<0.05). DHI score and the number of abnormal mCTSIB showed a statistically significant correlation.
Conclusions
We demonstrated the correlation between DHI score and mCTSIB after successful CRP for BPPV. It also represents that subjective residual dizziness is correlated with objective postural imbalance even after successful CRP. Therefore, mCTSIB would be a useful test to evaluate both residual dizziness and postural imbalance after CRP in BPPV.

Citations

Citations to this article as recorded by  
  • Immediate Improvement in Subjective Visual Vertical and Disequilibrium Predicts Resolution of Benign Paroxysmal Positional Vertigo Following Single Canalith Repositioning Maneuver
    Christine C. Little, Zachary G. Schwam, Marc Campo, James Gurley, Bryan Hujsak, Maura K. Cosetti, Jennifer Kelly
    Otology & Neurotology Open.2022; 2(3): e014.     CrossRef
  • Gait and Postural Control Characteristics among Individuals with Benign Paroxysmal Positional Vertigo: A Scoping Review
    Haziqah Nasruddin, Maria Justine, Haidzir Manaf
    Malaysian Journal of Medicine and Health Sciences.2022; 18(s15): 377.     CrossRef
Which Is More Important for the Prognosis of Sudden Sensorineural Hearing Loss with Vertigo, Canal Paresis or Benign Paroxysmal Positional Vertigo?
Yong-Hwi An, Hyun Joon Shim
Res Vestib Sci. 2021;20(3):101-107.   Published online September 15, 2021
DOI: https://doi.org/10.21790/rvs.2021.20.3.101
  • 3,336 View
  • 55 Download
  • 1 Crossref
AbstractAbstract PDF
Objectives
This study was performed to determine characteristics and the prognostic values in idiopathic sudden sensorineural hearing loss (SSNHL) with comorbid ipsilateral canal paresis (CP) and/or benign paroxysmal positional vertigo (BPPV).
Methods
Of the 338 patients with a diagnosis of idiopathic SSNHL, 29 patients (8.6%) with CP and 24 patients (7.1%) with BPPV were recruited and compared to 23 patients with SSNHL and vertigo but without CP or BPPV. The patients were evaluated for their initial hearing threshold, type of canal involved, response to repositioning maneuvers, and hearing outcome for 6 months.
Results
Patients with CP (+) BPPV (‒) showed lower pure-tone averages than those with CP (‒) BPPV (+) on initial and follow-up audiograms. The improvement in pure-tone averages was less in the CP (+) BPPV (‒) group than in the CP (‒) BPPV (+) group. The improvement in speech discrimination scores was less in the CP (+) BPPV (‒) group than in the CP (‒) BPPV (‒) group. BPPV most commonly involved the posterior canal (15 of 24, 62.5%), followed by the horizontal canal (13 of 24, 54.2%). Three of 24 patients (12.5%) had recurrences of BPPV.
Conclusions
CP is a more serious sign for hearing recovery than BPPV, although both CP and BPPV are negative prognostic indicators of auditory function in SSNHL. Concurrent CP and/or BPPV in SSNHL suggest combined damage to the vestibule and may indicate severe and widespread labyrinthine damage, leading to a poor prognosis.

Citations

Citations to this article as recorded by  
  • Re-fixation Saccade at Video-Head Impulse Test in Patients with Sudden Sensorineural Hearing Loss
    Dong Hyuk Jang, Sun Seong Kang, Hyun Joon Shim, Yong-Hwi An
    Research in Vestibular Science.2023; 22(2): 46.     CrossRef
Clinical Characteristics of Recurrent Benign Paroxysmal Positional Vertigo: A Retrospective Cohort Study
Jae-Myung Kim, Bang-Hoon Cho, Jong-Kyung Lee, Myeong-Kyu Kim, Seung-Han Lee
Res Vestib Sci. 2021;20(2):45-50.   Published online June 14, 2021
DOI: https://doi.org/10.21790/rvs.2021.20.2.45
  • 4,313 View
  • 70 Download
AbstractAbstract PDFSupplementary Material
Objectives
Benign paroxysmal positional vertigo (BPPV) is a potentially recurrent disease even after successful canalith repositioning maneuvers. However, the exact recurrence rate or any clinical factors affecting the recurrence of BPPV still need to be elucidated.
Methods
We recruited patients diagnosed as BPPV in a tertiary hospital for 3 years. We retrospectively reviewed the clinical information of the patients including baseline demographics, comorbidities and predisposing factors through the electronic medical records. We performed a telephone survey or direct interview 3 to 6 years later from the initial diagnosis of BPPV was made. To determine the factors associated with the recurrence, we divided study population into two subgroups; ‘recurrence group’ vs. ‘recurrence-free group.’ Then, intergroup comparative analyses were performed.
Results
Among 397 patients who were originally eligible for the study, we performed a telephone survey or direct interview in 289 patients (72.8%) to determine the recurrence of BPPV. The overall recurrence rate was 29.4% (85 of 289). Baseline demographics except female gender (p=0.014) were not different between subgroups. Neither clinical characteristics nor vascular comorbidities were associated with the recurrence. However, patients with low bone mineral density (BMD; T-score below ‒1, osteopenia/osteoporosis) showed significantly higher recurrence than those with normal BMD (40.6% vs. 0%, p=0.009).
Conclusions
Female gender and low BMD (T-score below ‒1) were associated with the recurrence of BPPV in this study. Further researches in various clinical settings with larger sample size are warranted to identify the factors affecting the relapse of BPPV.
Review
Benign Paroxysmal Positional Vertigo: Diagnostic Criteria and Updated Practice Guideline in Diagnosis
Dae Bo Shim
Res Vestib Sci. 2020;19(4):111-119.   Published online December 15, 2020
DOI: https://doi.org/10.21790/rvs.2020.19.4.111
  • 7,170 View
  • 402 Download
AbstractAbstract PDF
Benign paroxysmal positional vertigo (BPPV) is the most common cause of recurrent vertigo that is characterized by sudden onset of vertigo elicited by positional change. American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and American Academy of Neurology provided clinical practice guideline for BPPV in 2008. Since then, Bárány Society has published BPPV diagnostic criteria in 2015, and AAO-HNS has revised BPPV clinical practice guideline in 2017 to publish update version. This article reviewed recent diagnostic criteria for BPPV included in the International Classification of Vestibular Disorders of Bárány Society and updated practice guideline in the BPPV diagnosis presented by AAO-HNS.
Original Articles
The Periodic Fluctuation of Intra-Annual Distribution of Benign Paroxysmal Positional Vertigo and Meteorological Parameters
Chae Dong Yim, Ki Ju Cho, Hyun Jin Lee, Dong Gu Hur, Rock-Bum Kim, Seong-Ki Ahn
Res Vestib Sci. 2020;19(3):99-103.   Published online September 15, 2020
DOI: https://doi.org/10.21790/rvs.2020.19.3.99
  • 4,410 View
  • 70 Download
AbstractAbstract PDF
Objectives
The influence of specific meteorological conditions, such as solar radiation quantity, duration of sunshine, and their covariation on the incidence of benign paroxysmal positional vertigo (BPPV) has been rarely investigated. Aiming at better predictions of the monthly variation of BPPV, we investigated variations in the monthly incidence of BPPV patients and meteorological parameters.
Methods
A total of 2,111 patients who had been diagnosed with BPPV at one institution were analyzed retrospectively. Monthly counts of BPPV patients were analyzed for incidence distributions throughout the 5 years. The relationship between intra-annual distribution of BPPV and meteorological parameters was compared by the time series analysis.
Results
The lowest monthly incidence of BPPV patients was found in September and the highest monthly incidence was found in December. Statistically, as a result of the time series analysis, a periodic fluctuation of both quantity of solar radiation (p=0.004) and percentage of sunshine duration (p=0.002) was identified, but a periodic fluctuation of both number of BPPV patients (p=0.316) and sunshine duration (p=0.057) was not identified.
Conclusions
Unlike previous studies, the results of time series analysis did not confirm that there is a periodic fluctuation in the incidence of BPPV patients. The incidence of BPPV may be more affected by other factors than by meteorological parameters.
Intravenous Zoledronic Acid in Elderly Patients with Benign Paroxysmal Positional Vertigo and Osteoporosis
Dong Won Kwack, Hyemi Lee, Dong Wook Kim
Res Vestib Sci. 2020;19(3):95-98.   Published online September 15, 2020
DOI: https://doi.org/10.21790/rvs.2020.19.3.95
  • 6,148 View
  • 81 Download
AbstractAbstract PDF
Objectives
Benign paroxysmal positional vertigo (BPPV), a common cause of vertigo in the elderly, shares common pathogenic mechanisms with osteoporosis. We investigated the efficacy and safety of intravenous zoledronic acid in elderly patients with BPPV and osteoporosis.
Methods
We performed a 3-year observational study with elderly patients who were diagnosed with BPPV and osteoporosis. The recurrence of BPPV and changes in bone mineral densitometry (BMD) scores were evaluated one year after the administration of intravenous zoledronic acid.
Results
We enrolled 101 elderly patients with BPPV and 54 of them (53.5%) met the diagnostic criteria for osteoporosis. Intravenous zoledronic acid was administered in 51 patients. The recurrence of BPPV was observed in only two of 49 patients (4.1%) at 1 year’s follow-up. The mean lowest T-score of BMD improved from –3.23±0.51 to –3.05±0.58 (p=0.001).
Conclusions
Our study showed that the treatment of osteoporosis can be considered to prevent the recurrence of BPPV in the elderly. Further placebo-controlled studies are needed to estimate accurately the efficacy of zoledronic acid in the prevention of recurrence of BPPV in the elderly.
Clinical Characteristics of Sudden Sensorineural Hearing Loss Accompanying Benign Paroxysmal Positional Vertigo
Sung Min Park, Bin Kwon, Sung Won Li, Seok Min Hong, Sung Kyun Kim
Res Vestib Sci. 2020;19(2):71-78.   Published online June 15, 2020
DOI: https://doi.org/10.21790/rvs.2020.19.2.71
  • 5,282 View
  • 120 Download
  • 1 Crossref
AbstractAbstract PDF
Objectives
Idiopathic unilateral sudden sensorineural hearing loss (SSNHL) with simultaneous benign paroxysmal vertigo (BPPV) is known to be associated with poor hearing recovery. We aimed to investigate clinical findings in patients with SSNHL with BPPV and analyze prognostic factors including presence of BPPV related to hearing outcome.
Methods
We retrospectively reviewed the electronic medical data of 14 patients with concurrent SSNHL and BPPV (combined group). We selected 52 patients without BPPV as a control group who have matched initial threshold of pure tone audiometry and age of each patient in the combined group. We evaluated clinical characteristics of all participants and compared hearing outcomes between the 2 groups. A multivariate logistic regression analysis was performed to investigate the factors related to hearing recovery.
Results
Initial mean pure tone audiometry (PTA) threshold of combined group was 90.36±26.2 dB. Posterior canal was most commonly involved (n=7, 50%), and 8 (57%) patients showed abnormal video head impulse test results. There was no significant difference between hearing recovery rates of combined and control group (p=0.237) and mean pure tone audiometry threshold changes were not significantly different between the 2 groups (p=0.942). Old age (≥60 years), high initial PTA threshold (>90 dB), and obesity (body mass index ≥ 25 kg/m2) were poor prognostic predictors.
Conclusions
There was no difference between hearing outcomes of combined group and profound SSNHL only group. BPPV was not a significant prognostic factor of SSNHL patients.

Citations

Citations to this article as recorded by  
  • Which Is More Important for the Prognosis of Sudden Sensorineural Hearing Loss with Vertigo, Canal Paresis or Benign Paroxysmal Positional Vertigo?
    Yong-Hwi An, Hyun Joon Shim
    Research in Vestibular Science.2021; 20(3): 101.     CrossRef
Influence of Otoliths on the Vestibulo-Ocular Reflex in Horizontal Canal Benign Paroxysmal Positional Vertigo
Hee Soo Yoon, Jae Yeong Jeong, Jae Ho Chung, Ha Young Byun, Chul Won Park, Seung Hwan Lee
Res Vestib Sci. 2020;19(2):49-54.   Published online June 15, 2020
DOI: https://doi.org/10.21790/rvs.2020.19.2.49
  • 7,582 View
  • 123 Download
AbstractAbstract PDF
Objectives
The aim of the study was to evaluate the possible alteration of the vestibulo-ocular reflex (VOR) in patients with horizontal canal benign paroxysmal positional vertigo (h-BPPV) using the video head impulse test (vHIT).
Methods
This was a prospective case-control study of BPPV patients. We includeed 133 patients with h-BPPV who underwent the vHIT prior to the positioning test. The control group consisted of 76 normal subjects who also underwent the vHIT. The vHIT parameters of gain and asymmetry were assessed, and clinical parameters such as treatment duration, number of canalith reposition maneuvers executed and recurrence rates were evaluated. The VOR and clinical parameters were compared between the h-BPPV and control group. The VOR parameters of h-BPPV canalolithiasis were also compared with those of cupulolithiasis.
Results
The mean age of the patients was 56.5 years and the male to female ratio was 1:2.02. Of the patients, 75 were diagnosed as having the canalolithiasis type of h-BPPV, while the other 58 had the cupulolithiasis type. The mean vHIT gains of the ipsi-lesional horizontal canal plane were 1.13 and 1.15 in the h-BPPV and control group, respectively (p=0.564). However, the asymmetry of the VOR was significantly higher in the h-BPPV than the control group (p=0.013), while the gains and asymmetries of the vHIT in the canalolith and cupulolith types were not significantly different (p=0.454, p=0.826).
Conclusions
The asymmetry of VOR is significantly elevated in the cupulolith type of hBPPV.

Res Vestib Sci : Research in Vestibular Science