Canalith Jam as a Novel Complication of Stapes Surgery: A Case Report.
5 affiliations
- 1Otolaryngology Department, Entre o Douro e Vouga Local Health Unit, Santa Maria da Feira, Portugal.
- 2MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal.
- 3Vertigo Unit, Instituto CUF Porto, Porto, Portugal.
- 4Department of Biomedicine, Experimental Biology Unit, Faculty of Medicine of Porto, University of Porto, Porto, Portugal.
- 5ENT Unit, Department of Surgery, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Abstract
Postoperative vertigo is a complication of stapes surgery, sometimes associated with benign paroxysmal positional vertigo (BPPV). Among its variants, a canalith jam is a rare entity characterized by mechanical obstruction of endolymphatic flow by otoconia with subsequent canal-specific hypofunction. We present the case of a 37-year-old male who developed disabling persistent vertigo and imbalance with positional exacerbation following right-sided stapedotomy with canalplasty. Clinical evaluation revealed subtle positional nystagmus, isolated right posterior semicircular canal hypofunction on the video head impulse test (vHIT), and preserved cervical vestibular-evoked myogenic potentials. Based on these findings, posterior canalith jam was hypothesized. Symptom remission was achieved acutely after performing the Bascule maneuver, which produced an abrupt and sustained improvement in symptoms and vHIT trace. There was an improvement in gain and saccade pattern on the affected canal, noted immediately after symptom resolution. The patient returned to full daily and sporting activities with long-term resolution of vertigo. This case highlights posterior canalith jam as a possible complication of stapedotomy. The selective canal dysfunction documented by vHIT was essential for diagnosis and monitoring. Recognition of this mechanism is clinically relevant, as it expands the spectrum of postoperative vestibular complications and underscores the role of targeted rehabilitation in ensuring recovery.
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BibTeX
@article{camposlopes2026canalith,
title = {{Canalith Jam as a Novel Complication of Stapes Surgery: A Case Report.}},
author = {Miguel Campos-Lopes and Ângela Reis Rego and Luciana Rodrigues and Ana Raquel Andrade and Diogo Nascimento and Maria Inês Ribeiro and Alexandra Correia and Paulo Gonçalves and Andrea Castellucci},
journal = {Journal of otology},
year = {2026},
month = oct,
doi = {10.26599/joto.2026.9540081},
url = {https://europepmc.org/article/MED/42996649},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Canalith Jam as a Novel Complication of Stapes Surgery: A Case Report.
AU - Miguel Campos-Lopes
AU - Ângela Reis Rego
AU - Luciana Rodrigues
AU - Ana Raquel Andrade
AU - Diogo Nascimento
AU - Maria Inês Ribeiro
AU - Alexandra Correia
AU - Paulo Gonçalves
AU - Andrea Castellucci
PY - 2026
DA - 2026/10/01
JO - Journal of otology
DO - 10.26599/joto.2026.9540081
UR - https://europepmc.org/article/MED/42996649
AB - Postoperative vertigo is a complication of stapes surgery, sometimes associated with benign paroxysmal positional vertigo (BPPV). Among its variants, a canalith jam is a rare entity characterized by mechanical obstruction of endolymphatic flow by otoconia with subsequent canal-specific hypofunction. We present the case of a 37-year-old male who developed disabling persistent vertigo and imbalance with positional exacerbation following right-sided stapedotomy with canalplasty. Clinical evaluation revealed subtle positional nystagmus, isolated right posterior semicircular canal hypofunction on the video head impulse test (vHIT), and preserved cervical vestibular-evoked myogenic potentials. Based on these findings, posterior canalith jam was hypothesized. Symptom remission was achieved acutely after performing the Bascule maneuver, which produced an abrupt and sustained improvement in symptoms and vHIT trace. There was an improvement in gain and saccade pattern on the affected canal, noted immediately after symptom resolution. The patient returned to full daily and sporting activities with long-term resolution of vertigo. This case highlights posterior canalith jam as a possible complication of stapedotomy. The selective canal dysfunction documented by vHIT was essential for diagnosis and monitoring. Recognition of this mechanism is clinically relevant, as it expands the spectrum of postoperative vestibular complications and underscores the role of targeted rehabilitation in ensuring recovery.
SN - 1672-2930
SN - 2524-1753
ER -