In BPPV, which statement correctly describes otolith involvement?

In BPPV, which statement correctly describes otolith involvement?

• A. Otolith dislodgement from the utricle into the semicircular canals
• B. Otoliths form anew in the cochlea
• C. The utricle remains unaffected
• D. The eardrum becomes eroded by otoliths

Answer: (A)

In BPPV, the key idea is that otoconia (the calcium carbonate crystals that normally sit in the utricle and saccule) become dislodged and migrate into one of the semicircular canals. When the head moves, these crystals move with the endolymph and deflect the hair cells in the canal, creating erroneous signals of rotation and triggering vertigo with positional changes. This is why the most accurate statement is that otoliths are dislodged from the utricle into the semicircular canals. The other ideas don’t fit the mechanism: otoliths aren’t formed anew in the cochlea, they aren’t eroding the eardrum, and while the utricle is a source of otoconia (and can be involved in the process), the description that the utricle remains unaffected isn’t correct in the context of BPPV’s pathophysiology.

In BPPV, the key idea is that otoconia (the calcium carbonate crystals that normally sit in the utricle and saccule) become dislodged and migrate into one of the semicircular canals. When the head moves, these crystals move with the endolymph and deflect the hair cells in the canal, creating erroneous signals of rotation and triggering vertigo with positional changes. This is why the most accurate statement is that otoliths are dislodged from the utricle into the semicircular canals.

The other ideas don’t fit the mechanism: otoliths aren’t formed anew in the cochlea, they aren’t eroding the eardrum, and while the utricle is a source of otoconia (and can be involved in the process), the description that the utricle remains unaffected isn’t correct in the context of BPPV’s pathophysiology.