<?xml version="1.0" encoding="utf-8"?>
			<journal>
			<title>Iranian Journal of Otorhinolaryngology</title>
			<title_fa></title_fa>
			<short_title></short_title>
			<subject>Medical Sciences</subject>
			<web_url>https://ijorl.mums.ac.ir/</web_url>
			<journal_hbi_system_id>0</journal_hbi_system_id>
			<journal_hbi_system_user></journal_hbi_system_user>
			<journal_id_issn>2251-7251</journal_id_issn>
			<journal_id_issn_online>2251-726X</journal_id_issn_online>
			<journal_id_pii></journal_id_pii>
			<journal_id_doi></journal_id_doi>
			<journal_id_iranmedex></journal_id_iranmedex>
			<journal_id_magiran></journal_id_magiran>
			<journal_id_sid></journal_id_sid>
			<journal_id_nlai></journal_id_nlai>
			<journal_id_science></journal_id_science>
			<language>en</language>
			<pubdate>
				<type>jalali</type>
				<year>0</year>
				<month>0</month>
				<day>1</day>
			</pubdate>
			<pubdate>
				<type>gregorian</type>
				<year>2026</year>
				<month>5</month>
				<day>1</day>
			</pubdate>
			<volume>38</volume>
			<number>3</number>
			<publish_type>online</publish_type>
			<publish_edition>1</publish_edition>
			<article_type>fulltext</article_type>
			<articleset><article>
				<language>en</language>
				<article_id_issn></article_id_issn>
				<article_id_issn_online></article_id_issn_online>
				<article_id_pubmed></article_id_pubmed>
				<article_id_pii></article_id_pii>
				<article_id_doi></article_id_doi>
				<article_id_iranmedex></article_id_iranmedex>
				<article_id_magiran></article_id_magiran>
				<article_id_sid></article_id_sid>
				<title_fa></title_fa>
				<title>Novel Case of Bilateral Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo with Asymmetric Mechanisms: Left Cupulolithiasis and Right Short-Arm Canalolithiasis</title>
				<subject_fa></subject_fa>
				<subject></subject>
				<content_type_fa></content_type_fa>
				<content_type>Case Report</content_type>
				<abstract_fa><![CDATA[]]></abstract_fa>
				<abstract><![CDATA[Introduction:Benign paroxysmal positional vertigo (BPPV) involving multiple semicircular canals (MC-BPPV) is an uncommon variant in which otoconia dislodged from the utricular macula migrate into two or more canals, provoking brief vertigo episodes with positional changes. The single-canal variant predominates, most often affecting the posterior canal, followed by the horizontal and anterior canals. MC-BPPV typically presents with ipsilateral or contralateral posterior-horizontal canal combinations, while atypical posterior canal variants are rarer and require careful nystagmus evaluation during positional testing.Case Report:A 62-year-old man presented with a one-day history of vertigo triggered by rising from the supine position, along with retropulsion and vertigo during transitions to lateral recumbent positions. Standard right Dix-Hallpike test (DHT) and right half DHT were unremarkable. Augmented right half-DHT elicited persistent upbeat right-torsional nystagmus; a negative inversion test indicated right short-arm posterior canalolithiasis. Left half-DHT evoked persistent left torsional upbeating nystagmus that reversed to downbeating nystagmus with a subtle right-torsional component on right lateral rolling nose-down, consistent with left posterior cupulolithiasis. The Bascule maneuver was used to treat the left ear, and the prone pitch-and-yaw maneuver was used to treat the right ear. Follow-up showed conversion of left posterior cupulolithiasis to typical canalolithiasis, which resolved with the Epley maneuver, resulting in complete symptom remission.Conclusions:This case highlights the importance of comprehensive positional testing and mechanism-specific therapeutic maneuvers for successful management of atypical bilateral MC-BPPV. ]]></abstract>
				<keyword_fa></keyword_fa>
				<keyword>Benign paroxysmal positional vertigo, Multi-canal BPPV, Cupulolithiasis, Canalolithiasis, Posterior semicircular canal, Positional nystagmus</keyword>
				<start_page>197</start_page>
				<end_page>201</end_page>
				<web_url>https://ijorl.mums.ac.ir/article_27784.html</web_url>
			<author_list><author>
				<first_name>Shreya</first_name>
				<middle_name></middle_name>
				<last_name>Vats</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email>shreyavats16@gmail.com</email>
				<code>122149</code>
				<coreauthor>No</coreauthor>
				<affiliation>Clinical Vestibulology Observer, Otoneurology Centre, 6-A, Block-B, Shikarbadi, Udaipur-313001, Rajasthan, India.</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Ajay</first_name>
				<middle_name>Kumar</middle_name>
				<last_name>Vats</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email>vatsneuro@gmail.com</email>
				<code>122150</code>
				<coreauthor>Yes</coreauthor>
				<affiliation>Consultant Neurophysician, ShantiRaj Hospital Kesar Kunj, New Bhupal Pura, Udaipur, India.</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author><author>
				<first_name>Sudhir</first_name>
				<middle_name></middle_name>
				<last_name>Kothari</last_name>
				<suffix></suffix>
				<first_name_fa></first_name_fa>
				<middle_name_fa></middle_name_fa>
				<last_name_fa></last_name_fa>
				<suffix_fa></suffix_fa>
				<email>sudhirkothari@gmail.com</email>
				<code>122151</code>
				<coreauthor>No</coreauthor>
				<affiliation>Department of Neurology, Poona Hospital and Research Centre, Pune, Maharashtra, India.</affiliation>
				<affiliation_fa></affiliation_fa>
				 </author></author_list>
				</article>
			</articleset>
			</journal>