Efficacy of a Treatment Procedure Combining Inertial and Gravity Loading for Lateral Semicircular Canal Benign Paroxysmal Positional Vertigo (Cupulolithiasis)

Abstract

Objective: In this study, we sought to improve the treatment outcomes of lateral semicircular canal benign paroxysmal positional vertigo (cupulolithiasis) through a new treatment procedure that combines inertial and gravity loading.

Materials and Methods: We retrospectively evaluated the treatment efficacy of combined inertial and gravity loading in 15 patients with lateral semicircular canal benign paroxysmal positional vertigo (cupulolithiasis) who visited our clinic between June 2021 and November 2022.

Results: The treatment procedure yielded an immediate effect in 10 of 15 patients (66.7%). Inertial loading resulted in successful detachment of the otoliths from the cupula in 4 of the 15 patients (26.7%), whereas gravity loading, which was added in the 11 patients in whom the otoliths remained undetached from the cupula following inertial loading, led to successful detachment of the otoliths from the cupula in 6 patients (54.5%).

Conclusion: This treatment procedure for lateral semicircular canal benign paroxysmal positional vertigo (cupulolithiasis) was more effective than the other treatment procedures, with our findings showing that gravity loading, even for a short duration, was useful for detaching the otoliths from the cupula.