Immediate repeated testing (IRT) for BPPV: A cost-effective examination

Mariam H Mella; Elena Al Hakim; Jihad Khoury; Fouad Fata

doi:10.1002/lio2.800

Immediate repeated testing (IRT) for BPPV: A cost-effective examination

Laryngoscope Investig Otolaryngol. 2022 Apr 22;7(3):832-834. doi: 10.1002/lio2.800. eCollection 2022 Jun.

Authors

Mariam H Mella¹, Elena Al Hakim¹, Jihad Khoury¹, Fouad Fata¹

Affiliation

¹ Department of Otolaryngology Saint George Hospital University Medical Center Beirut Lebanon.

Abstract

Objective: To show that a negative Dix-Hallpike test or Pagnini-McClure test may convert into positive after head shaking in cases of semicircular canalith jam.

Methods: This is a retrospective study, where 768 cases of BPPV were studied of which 36 were found to have canalith jam.

Results: Thirty-six patients (4.7%) presented with canalith jam; 4.8% of posterior canal BPPV and 3.7% of lateral canal BPPV were attributed to canalith jam.

Conclusion: Immediate repeated testing for BPPV allows us to identify undiagnosed cases of BPPV where canalith jam has occurred. It is a cost-effective technique that provides benefits for clinicians, patients, and the healthcare system.

Keywords: Epley; benign paroxysmal positional vertigo; canalith jam; level 4 evidence.