Peñarrocha M, Pérez H, Garciá A, Guarinos J. Benign paroxysmal positional vertigo as a complication of osteotome expansion of the maxillary alveolar ridge. J Oral Maxillofac Surg. 2001 Jan;59(1):106-7.
Benign paroxysmal positional vertigo (BPPV) is a common vestibular end organ disorder characterized by short, often recurrent episodes of vertigo that are triggered by certain head movements in the plane of the posterior semicircular canals. BPPV may be idiopathic or secondary to a number of underlying conditions such as head injury, viral labyrinthitis, stapes surgery, and chronic suppurative otitis media.
The most commonly accepted theory postulates the development of BPPV as a result of canalolithiasis, heavy, inorganic particles detached from the otoconial layer by degeneration or head trauma gravitate into the posterior semicircular canal and act as a plunger on the endolymph and cupule so that if the head is turned and the angle between the canal plane and gravity vector is altered, it triggers vertigo. Canalolith repositioning procedures4 and freeing maneuvers have been used to treat BPPV. Surgery may help patients refractory to physical therapy when the symptoms are sufficiently severe to significantly hinder them from carrying out normal daily activities.
We present a case in which very intense BPPV developed during surgical maneuvering of the patient to place implants in the upper jaw.