Diagnosis and treatment of the short-arm type posterior semicircular canal BPPV

Abstract

Introduction: The Epley maneuver is useful for the otoconia to return from the long arm of the posterior semicircular canal into the utricle. To move otoconia out of the posterior semicircular canal short arm and into the utricle, we need different maneuvers. Objective: To diagnose the short-arm type BPPV of the posterior semicircular canal and treat them with bow-and-yaw maneuver. Methods: 171 cases were diagnosed as BPPV of the posterior semicircular canal based on a positive Dix–Hallpike maneuver. We first attempted to treat patients with the bow-and-yaw maneuver and then performed the Dix–Hallpike maneuver again. If the repeated Dix–Hallpike maneuver gave negative results, we diagnosed the patient with the short-arm type of BPPV of the posterior semicircular canal and considered the patient to have been cured by the bow-and-yaw maneuver; otherwise, probably the long-arm type BPPV of the posterior semicircular canal existed and we treated the patient with the Epley maneuver. Results: Approximately 40% of the cases were cured by the bow-and-yaw maneuver, giving negative results on repeated Dix–Hallpike maneuvers, and were diagnosed with short-arm lithiasis. Conclusion: The short-arm type posterior semicircular canal BPPV can be diagnosed and treated in a convenient and comfortable manner.