New Treatment Strategy for Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo.

The apogeotropic variant of horizontal semicircular canal benign paroxysmal positional vertigo (HC-BPPV) is attributed to canalithiasis of the anterior arm or cupulolithiasis. Despite some therapeutic maneuvers, I propose a new treatment strategy for apogeotropic HC-BPPV that is designed to detach both the otoconial debris from the anterior arm of the semicircular canal and the debris that is attached to the utricular side of the cupula using inertia and gravity and based on simulations with a 3D biomechanical model.