cupulolithiasis

cupulolithiasis

 [ku″pu-lo-lĭ-thi´ah-sis]
the presence of calculi in the cupula of the posterior semicircular duct.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

be·nign par·ox·ys·mal positional ver·ti·go

a recurrent, brief form of positional vertigo occurring in clusters; believed to result from displaced remnants of utricular otoconia into the semicircular ducts, usually the posterior.
Farlex Partner Medical Dictionary © Farlex 2012

benign paroxysmal positional vertigo

A form of transient vertigo caused by utricular degeneration which liberates otoconia: otoconia drift into the lower part of the vestibule, the ampulla of the posterior semicircular canal; once there, the otoconia alter the cupola’s specific gravity, changing its response characteristics from a purely angular acceleration detector to one that is stimulated by linear movements and gravity.
 
Incidence
BPPV is a common form of vertigo, more common in older adults.
 
Aetiology
Closed head injury, vestibular neuronitis, infections, post-stapedectomy.
 
Diagnosis
History—e.g., single bouts of severe vertigo of < 1 min in duration after a change in head position, often more severe on one side, when bending, looking to take an object off a shelf or tilting the head back; the episodes are clustered in time and separated by remissions lasting months or more; Hallpike maneuver.
 
Management
Particle repositioning maneuver; occlusion of affected canal using a bone chop:fibrinogen glue plug; most BPPV resolves spontaneously within several months of onset, especially following head injury; persistent, near-disabling symptoms may mandate surgery: singular neurectomy, vestibular neurectomy or posterior semicircular canal occlusion.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.
References in periodicals archive ?
There are two possible pathophysiologic mechanisms that lead to BPPV: canalithiasis or cupulolithiasis (6, 7).
Multicanal BPPV is addressed by treating canalolithiasis before cupulolithiasis and repositioning posterior canal otoliths before horizontal canal otoliths.
Several maneuvers based on cupulolithiasis and canalolithiasis theories have been proposed for BPPV treatment by Brandt, Daroff, Norre, Beckers, and McCabe.4-6 Presently, the most widely used maneuver for the treatment of posterior canal BPPV is the canalith repositioning procedure of Epley.7
BPPV is characterized by a sense of vertigo that arises in certain head positions (2), and the pathophysiology of the disease is based on two major theories: cupulolithiasis (3) and canalithiasis (4).
Benign paroxysmal positional vertigo is the most common etiology of recurrent vertigo and is caused by abnormal stimulation of the cupula by free-floating otoliths (canalolithiasis) or otoliths that have adhered to the cupula (cupulolithiasis) within any of the three semicircular canals.
Steddin, "Current view of the mechanisms of benign paroxysmal positioning vertigo: cupulolithiasis or canalolithiasis?," Journal of Vestibular Research, vol.
Canalithiasis refers to the displacement of otoconia located within the gelatinous membrane in the macula into the semicircular canals, whereas cupulolithiasis defines the adherence of these particles to the cupula of the semicircular canals.
BPV can result from canalolithiasis where the otoconia are freely floating in the duct of the semicircular canal or cupulolithiasis where the otoconia are adherent to the cupula.
The two main hypothesis; which explain the development of BPPV are the cupulolithiasis and canalithiasis theory, which is based on the presence of free- floating debris in the lumen of the canal which is the cause of vertigo4.
Two proposed causes of vertigo are canalithiasis and cupulolithiasis, which are often cited to explain benign paroxysmal positional vertigo (BPPV) in particular.
Canalithiasis and cupulolithiasis are the most likely mechanisms underlying BPPV.
In 1969, Schucknecht proposed another form of this theory named as "cupulolithiasis" and demonstrated the attached otoconia to the cupula of PSCC of the affected side (6-8).