*Department of Otorhinolaryngology, Yonsei University College of Medicine; and †Department of Otology, Hana ENT Hospital, Seoul, Republic of Korea.
Otol Neurotol. 2013 Dec;34(9):1725-8. doi: 10.1097/MAO.0b013e318294227a.
To investigate the characteristics of canal conversion between the anterior and posterior semicircular canals in benign paroxysmal positional vertigo (BPPV).
Retrospective chart review.
Secondary referral center.
A total of 709 patients who were treated with the Epley maneuver for BPPV of the anterior or posterior semicircular canal.
Vestibular examinations with videonystagmography and the canalith repositioning procedure (CRP) to treat BPPV.
Canal conversion between the anterior and posterior semicircular canals was observed in 18 (2.9%) patients who underwent CRP. In 13 (2.3%) of 564 patients initially diagnosed with posterior canal BPPV (PC-BPPV), switch to anterior canal BPPV (AC-BPPV) was observed at a follow-up visit. In 5 (12.1%) of 41 patients who presented with AC-BPPV, canal switch to PC-BPPV occurred more frequently (p = 0.005). The average number of CRPs before nystagmus resolution was 3.6 in conversion cases versus 1.6 in the nonconversion group (p < 0.001).
Canal conversion between the anterior and posterior semicircular canals can occur during treatment. The possibility of canal conversions should be considered for appropriate management of BPPV of the vertical semicircular canals.
探讨良性阵发性位置性眩晕（BPPV）中前、后半规管之间管转换的特征。
回顾性图表回顾。
二级转诊中心。
共 709 例接受 Epley 手法治疗前或后半规管 BPPV 的患者。
前庭检查伴视频眼震图和耳石复位程序（CRP）治疗 BPPV。
18 例（2.9%）接受 CRP 的患者观察到前、后半规管之间的管转换。在最初诊断为后半规管 BPPV（PC-BPPV）的 564 例患者中，有 13 例（2.3%）在随访时观察到转换为前半规管 BPPV（AC-BPPV）。在 41 例表现为 AC-BPPV 的患者中，更常发生管转换为 PC-BPPV（p = 0.005）。在管转换病例中，眼震消退前的 CRP 平均次数为 3.6 次，而非转换组为 1.6 次（p < 0.001）。
在前、后半规管之间治疗过程中可能会发生管转换。对于垂直半规管 BPPV 的适当管理，应考虑管转换的可能性。
