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OVER 98% PASS RATE FOR THE NCS, OCS, AND PCS EXAMS forums NCS Advantage Is BBQ roll test good for both canalithiasis and capulolithiasis?

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    • #489696
      Alex Turcios


      just want to confirm if its good for both or good just for the canalithiasis. I am seeing different things from different sources. Thanks!

    • #489699

      Hi Alex,
      In my experience, the BBQ roll is just for canalithiasis. For cupulolithiasis, we generally want to start with a fast movement like the modified Liberatory/Semont to displace the otoconia and convert cupulolithiasis to canalithiasis. After conversion, we would then do a canalithiasis treatment like the BBQ roll.

    • #489704
      Alex Turcios

      Whaaaaattttt, I never thought if it like that. I guess, what makes the difference between the two in a physiologic level. Are you saying that cupulolithiasis is more severe or “advanced” since it needs to be converted to the shorter duration type of BPPV? Does this conversion hold true for cupulolithiasis of the posterior and anterior canals as well?

      • #489719

        In cupulolithiasis, the otoconia are attached to the cupula rather than free-floating in the canals. Cupulolithiasis is rarer are “stickier” than canalithiasis, but not necessarily more severe. Yes, same principal for anterior and posterior canal cupulolithiasis – convert to canalithiasis, then treat.

    • #489726
      Alex Turcios

      wow, good to know. thank you!

    • #489844
      Alex Turcios

      Thank you so much for your help hear, today I got to do this on a patient who was admitted to our hospital for 4 days without resolution of his symptoms!
      I did the roll test and determined that he had ageotrophic horizontal nystagmus that lasted over a minute. So this told me the impaired side was the side with weaker symptoms which was his right side. I performed the R semont, followed by the R BBQ roll. The patient said he felt better and when I checked on him several hours better, he stated “I feel much better, I am going home now”
      I felt so impowered, thank you!
      PS: was my assessment and techniques I chose correct? I hope it was all correct and it was not just dumb luck or random chance that the patient felt better…

      • #489847

        Awesome – congratulations on putting your new skills to work! It sounds like you nailed it. There are several options for treating most types of BPPV. For horizontal cupulolithiasis, the modified Semont/Casani is a common treatment. For horizontal canalithiasis, the BBQ roll and Apiani maneuvers are pretty equally effective.

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