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Upbeating nystagmus indicates that the vertigo is present in the posterior semicircular canal of the tested side.
For some patients, this maneuver may not be indicated and a modification may be needed that also targets the posterior semicircular canal.
The Dix-Hallpike test is a common test performed by examiners to determine whether the posterior semicircular canal is involved.
The posterior semicircular canal is a part of the vestibular system and detects rotations of the head in the sagittal plane.
It involves a reorientation of the head to align the posterior semicircular canal (at its entrance to the ampulla) with the direction of gravity.
There are six receptor organs located in the inner ear: cochlea, utricle, saccule, and the lateral, anterior, and posterior semicircular canals.
Multiple reports have shown that the retrosigmoid approach cannot reach the lateral end of the internal auditory canal without violating the posterior semicircular canal, and hence destroying the hearing.
Recent pathological findings also suggest that the displaced otoconia typically settle in the posterior semicircular canal in the cupula of the ampulla and render it sensitive to gravity.
The anterior and posterior semicircular canals detect rotations of the head in the sagittal plane (as when nodding), and in the frontal plane, as when cartwheeling.
The pointed apex "at the junction of the anterior and posterior semicircular canals" is caused by the near linearity of the canals and closely resembles the condition of modern crocodiles.
The canalicular systems and the cochlear process differ in both taxa, and the vestibular region is relatively small and located in a ventral position to most of the anterior and posterior semicircular canals.
When a therapist is performing the Epley or Modified Epley maneuver, the patient's head is rotated to 45 degrees in the direction of the affected side, in order to target the posterior semicircular canal of the affected side.