ArticleOTO open
Cupulolithiasis: A Critical Reappraisal.
Article in OTO open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Genome-Wide Association Study of Chronic Dizziness in the Elderly Identifies Loci Implicating MLLT10, BPTF, LINC01224, and ROS1.Journal of the Association for Research in Otolaryngology : JARO · 2023Pooled it
- Pathophysiological Variants of Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo: Toward an Integrative Model Based on Otoconial Location and Cupular Dynamics.Audiology research · 2026Review
- Development and validation of the SMART-BPPV: a multimedia learning module for BPPV education.BMC medical education · 2026Article
- Lying Down Nystagmus in Lateral Canal Paroxysmal Positional Vertigo.Audiology research · 2026Article
- Revisiting BPPV: Incidence and Behavior of Atypical Variants.Audiology research · 2025Article
- Sex and Age Differences in the Severity of Dizziness Complaints in Benign Paroxysmal Positional Vertigo (BPPV).Laryngoscope investigative otolaryngology · 2025Article
- Risk of Benign Paroxysmal Positional Vertigo Modified by Diuretics-A Population-Level Case-Control Study.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2025Article
- Epley's Influence on Horizontal Canal BPPV Variants.Audiology research · 2025Review
- Impact of Vibrations and Rapid Decelerations on SemontPLUS Maneuver Efficacy: An In Vitro Study.Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2025Article
- Clinical spectrum of positional downbeat nystagmus: a diagnostic approach.Journal of neurology · 2025Review
- The Intra-Examiner Variability in and Accuracy of Traditional Manual Diagnostics of Benign Paroxysmal Positional Vertigo: A Prospective Observational Cohort Study.Journal of clinical medicine · 2025Article
- Quantified assessment of 3D nystagmus in BPPV: practical considerations.Frontiers in neurology · 2025Article
- Impact of head orientation and head movement in traditional manual diagnostics of benign paroxysmal positional vertigo: a randomized controlled crossover study.Frontiers in neurology · 2025Article
- Comparative Study of Clinical Features of Patients with Different Types of Benign Paroxysmal Positional Vertigo.Journal of clinical medicine · 2024Article
- Understanding Benign Paroxysmal Positional Vertigo (BPPV) and Its Impact on Quality of Life: A Systematic Review.Cureus · 2024Review
- The spatial orientation of crista ampullaris: implications for BPPV diagnosis and treatment.Frontiers in neurology · 2024Article
- Residual dizziness after BPPV management: exploring pathophysiology and treatment beyond canalith repositioning maneuvers.Frontiers in neurology · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: To review the history and pathophysiologic theories for cupulolithiasis and canalith jam in benign paroxysmal positional vertigo. Data Sources: PubMed, Google Scholar. Review Methods: Three PubMed and Google Scholar searches were performed, keywords: "cupulolithiasis," "apogeotropic [and] benign," and "canalith jam," resulting in 187 unique full-text articles in English or with English translation. Figures-Labyrinthine photographs were obtained of fresh utricles, ampullae, and cupulae of a 37-day-old mouse. Conclusions: Freely moving otoconial masses explain most cases (>98%) of benign paroxysmal positional vertigo. Evidence that otoconia adhere strongly or persistently to the cupula is lacking. Apogeotropic nystagmus in the horizontal canal form is often attributed to cupulolithiasis; however, periampullary canalithiasis explains self-limited nystagmus, and reversible canalith jam explains prolonged apogeotropic nystagmus. Treatment-resistant cases can be explained by entrapment of particles in the canals or ampullae, but persistent adherence to the cupula remains theoretical. Implications for Practice: Apogeotropic nystagmus is usually due to freely moving particles and should not be used in studies of horizontal canal benign paroxysmal positional vertigo as the sole method to define entrapment or cupulolithiasis. Caloric testing and imaging may help differentiate jam from cupulolithiasis. Treatment for apogeotropic benign paroxysmal positional vertigo should include maneuvers that rotate the head through 270° to fully clear the canal of mobile particles, using mastoid vibration or head shaking if entrapment is suspected. Canal plugging can be used for treatment failures.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.