Lateralization of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) with the latency test: a pilot study. (3rd October 2019)

• Record Type: Journal Article
• Authors: Scarpa, Alfonso; Cassandro, Claudia; Gioacchini, Federico Maria; Viola, Pasquale; Cuofano, Rossella; Kaleci, Shaniko; Ralli, Massimo; Chiarella, Giuseppe; Cassandro, Ettore
• Is Part Of: Acta oto-laryngologica. Volume 139:Number 10(2019)
• Page Start: 854
• Page End: 859
• Publication Date: 2019-10-03
• Subjects: Benign paroxysmal positional vertigo -- latency test -- bow and lean test -- head rolling test -- lying-down nystagmus -- treatment -- diagnosis -- horizontal semicircular canal; Otolaryngology -- Periodicals; Ear -- Diseases -- Periodicals; Throat -- Diseases -- Periodicals; Otolaryngology -- Electronic Resources; Otorhinolaryngologic Diseases; 617.8
• DOI: 10.1080/00016489.2019.1635712
• Languages: English
• ISSNs: 0001-6489

Abstract

Abstract: Background: The treatments of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) have low remission rates ranging between 60% and 90%, connected to the difficulty in correctly identifying the affected side of HSC-BPPV. Objective: To propose and compare the efficacy of the latency test (LT) in identifying the affected ear in patients with HSC-BPPV. Materials and methods: Twenty-one subjects diagnosed with HSC-BPPV, as ascertained by head rolling test (HRT), were prospectively identified. Lateralization was assessed with pseudo-spontaneous nystagmus, lying-down nystagmus, bow and lean (BLT), HRT and LT tests. LT is a novel technique involving a 180° movement of the head and the analysis of the time required to reverse the nystagmus. Results: About 57% of patients were diagnosed with geotropic, and 43% with apogeotropic type HSC-BPPV. LT achieved a correct side diagnosis in 86%. Efficacy analysis of the tests compared to HRT revealed a substantial fair level of agreement for lying-down test ( κ = 0.32, p < .05), a slight level of agreement for BLT ( κ = 0.19, p < .05) and a substantial level of agreement for LT ( κ = 0.071, p < .001). Conclusions and significance: LT was proven to show a substantial level of agreement compared to HRT in identifying the affected ear in patients with HSC-BPPV in this pilot study.