The Role of High-Resolution Magnetic Resonance in Atypical and Intractable Benign Paroxysmal Positional Vertigo: Our Preliminary Experience

Vol. 69, No. 4, 2007

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Original Paper

The Role of High-Resolution Magnetic Resonance in Atypical and Intractable Benign Paroxysmal Positional Vertigo: Our Preliminary Experience
Iacopo Dallan^a, Luca Bruschini^a, Emanuele Neri^b, Andrea Nacci^a, Giovanni Segnini^c, Ferdinando Rognini^a, Augusto Pietro Casani^c

^aSecond ENT Unit, Azienda Ospedaliero-Universitaria Pisana,
^bDivision of Diagnostic and Interventional Radiology, Department of Oncology, University of Pisa, and
^cFirst ENT Unit, Department of Neuroscience, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy

Address of Corresponding Author

ORL 2007;69:212-217 (DOI: 10.1159/000101541)

Key Words

High-resolution magnetic resonance
Positional vertigo
Paroxysmal vertigo
Three-dimensional inner ear reconstruction
Therapeutic manoeuvres

Abstract

Background: The diagnosis of benign paroxysmal positional vertigo (BPPV) is easy when typical nystagmus is present. However, diagnostic doubts arise when faced with cases presenting atypical features of the positional paroxysmal nystagmus as well as the clinical course and disease evolution. Methods: A morphological evaluation of inner ear structures via high-resolution magnetic resonance (HR-MR) studies has been performed in 2 patients that did not respond to traditional therapeutic manoeuvres. Results: In 1 patient, a filling defect at the level of the middle portion of the right lateral semicircular canal (LSC) has been demonstrated, while in the second one, a geometric-architectural abnormality - a 'fold' in the LSC - has been observed. Conclusion: HR-MR study of the inner ear offers a meaningful contribution to interpreting the physiopathogenesis of atypical cases of BPPV. HR-MR of the inner ear is a safe and useful tool to investigate patients with atypical and intractable BPPV.

Author Contacts

Iacopo Dallan, MD
Second ENT Unit, Azienda Ospedaliero-Universitaria Pisana
Via Savi, 10
IT-56126 Pisa (Italy)
Tel. +39 050 993 284, Fax +39 050 993 239, E-Mail iacopodallan@tiscali.it

Article Information

Received: February 17, 2006
Accepted after revision: June 2, 2006
Published online: April 4, 2007
Number of Print Pages : 6
Number of Figures : 2, Number of Tables : 1, Number of References : 17

Medline Abstract (ID 17409779)

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