Granddaughter's somersault treats cupulolithiasis of the horizontal semicircular canal

Authors

• Dirk Czesnik, MD^, ,
• David Liebetanz, MD

• Department of Clinical Neurophysiology, Medical School Göttingen, Georg-August-University of Göttingen, Robert-Koch-Str. 40, Göttingen, Germany

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Abstract

We report on a 61-year-old woman with cupulolithiasis of the right horizontal semicircular canal, which is usually difficult to treat. 

The patient reported that several years ago, similar symptoms relieved completely after having performed several somersaults together with her granddaughter. 

This time, repetitive somersaults were again effective to treat her benign paroxysmal positional vertigo. 

Acceleration during a somersault may induce an intracanalicular force strong enough to detach otoconia debris from the cupula.

Rolling may then promote their reentrance into the utricle. This case suggests that repetitive somersaults may be an alternative treatment of cupulolithiasis of the horizontal semicircular canal.

Body rotation (A) and rotation of the horizontal semicircular canal during a somersault (B; lateral view). 
The gray line illustrates the position of horizontal semicircular canal. 
(C) The left picture illustrates how acceleration in the forward-facing direction during the somersault induce an intracanalicular force strong enough to detach otoconia debris from the cupula. 
The right picture demonstrates how ongoing rolling may move loose otoconia debris back into the utricle.

Fuente:

American Journal of Otolaryngology

Volume 34, Issue 1, January–February 2013, Pages 72–74