Children with single-sided deafness (SSD) may experience delays in language and speech development. Reduced speech discrimination and poor sound localization abilities in young SSD patients may result in greater cognitive efforts required to focus and process auditory information, as well as increased listening-related fatigue. Consequently, these children can have a higher risk of academic failure and are often in need of extra help at school. Recently, cochlear implants (CIs) have been introduced as a rehabilitative option for these children, but their effectiveness is still a topic of debate. A literature review was performed according to PRISMA guidelines, searching the Medline database from inception to October 2023. The research identified nine papers that met the inclusion criteria. Data extracted from the selected studies included 311 children affected by SSD and cochlear implants. The reported audiological outcomes were further analyzed. Overall, a high level of satisfaction was described by parents of children with SSD and CI, and those who received a CI under the age of 3 presented better results. However, a proportion of patients did not use the device daily. Our review highlights the possible, and still controversial, role of CI for the hearing rehabilitation of children with unilateral deafness, underlining the need for further research in this field. To date, careful and comprehensive counseling with the child and the family is necessary before considering this option.

Background: Posterior canal benign paroxysmal positional vertigo (PSC-BPPV) is the most frequently encountered vestibular disorder in otoneurological clinical practice. However, diagnosis may be challenging in the presence of less common variants, which are characterised by atypical nystagmus patterns and may complicate clinical assessment. Methods: This study analysed a cohort of 295 patients diagnosed with PSC-BPPV and treated between January and August 2025 at the Audiology and Phoniatrics Unit of San Pio Hospital, Benevento. Of these, 25 patients presented with less common PSC-BPPV variants, namely the apogeotropic variant, the Scocco variant, and the Yetiser variant. Clinical features, therapeutic manoeuvres performed, time to symptom resolution, and associated comorbidities were evaluated. All patients were treated exclusively using the Epley manoeuvre. This observational study describes our experience in the diagnosis and management of these rare PSC-BPPV variants, with the aim of expanding the currently available evidence. Results: The Scocco variant was the only less common form of PSC-BPPV that required a statistically significantly greater number of liberatory manoeuvres when compared with classic PSC-BPPV (p < 0.05). No statistically significant differences were observed for the remaining variants with regard to treatment response or time to symptom resolution. Conclusions: Less common variants of PSC-BPPV represent both diagnostic and therapeutic challenges due to their atypical nystagmus patterns. Our findings indicate that the Scocco variant may be more resistant to standard liberatory treatment. In addition, this study reports auxiliary diagnostic and clinical tools which, in our experience, facilitated patient management.

The points of contact between the vestibular system and the trigeminal nerve remain an active area of research. Anatomically, several connections have been clearly identified, and these may play a role in the development of various disorders. Understanding these connections also proves to be extremely valuable from a clinical perspective. It is increasingly evident that the etiopathogenesis of various vestibular disorders is multifactorial. Therefore, knowledge of the points of interaction between the two systems can assist clinicians in patient assessment and, most importantly, in selecting the most appropriate therapeutic approach. This study is presented as a narrative review. A literature search was conducted to identify studies investigating the correlation between the trigeminal system and the vestibular system, as well as their respective characteristics, to provide a comprehensive overview. Since this is a narrative rather than a systematic review, no specific inclusion or exclusion criteria were applied. So, the aim of this study is to analyze these connections through a comprehensive review of the literature, trying to present a multidisciplinary approach to the topic, one that can involve both the neurologist and the otologist, in order to achieve a more refined management of clinical cases. To better understand their anatomical relationships, we begin by examining the embryological development of both the vestibular system and the trigeminal nerve. Finally, we present current knowledge on the trigeminal influence in certain vestibular disorders—particularly vestibular migraine—and, conversely, the vestibular system’s potential impact on trigeminal-related conditions.

Background: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder and is typically diagnosed based on characteristic positional nystagmus. Although video head impulse testing (vHIT) is increasingly used in vestibular disorders, its role in BPPV remains unclear, particularly in less common variants. This systematic review and meta-analysis aimed to investigate vestibulo-ocular reflex (VOR) gain measured by vHIT in BPPV and to describe vHIT findings in less common variants. Methods: A systematic literature search identified studies reporting vHIT findings in patients with BPPV. For the quantitative synthesis, studies including at least 35 patients with common BPPV variants were eligible, and posterior semicircular canal (PSC) VOR gain was analysed using a random-effects meta-analysis. Less common variants were considered separately without a minimum sample-size criterion and qualitatively synthesised, including case reports, case series, and retrospective and prospective studies. Results: Ten studies met the inclusion criteria for the quantitative synthesis, while one study about typical BPPV underwent qualitative analysis and six studies investigated less common BPPV variants; one of these six studies also contributed to the quantitative synthesis. In typical PSC-BPPV, vHIT generally showed preserved vestibulo-ocular reflex function, with VOR gain within or close to the normal range. The pooled analysis showed no clinically relevant reduction in PSC VOR gain. In less common variants, vHIT findings were heterogeneous, although most patients showed preserved canal-specific VOR function. Conclusions: vHIT appears to have a limited role in the diagnosis of typical BPPV. However, it may provide additional diagnostic information in less common variants, where vestibular responses can be atypical. Further studies with larger and more homogeneous populations are needed to clarify the diagnostic and pathophysiological significance of vHIT findings in uncommon BPPV variants.

Background: Positional torsional downbeating nystagmus elicited during diagnostic maneuvers for posterior semicircular canal benign paroxysmal positional vertigo (PSC-BPPV) may indicate either ipsilateral apogeotropic PSC-BPPV or contralateral anterior canal BPPV, making differential diagnosis challenging. This retrospective study evaluated whether ipsilateral 100 Hz mastoid vibration could facilitate conversion to a geotropic nystagmus pattern, thereby supporting both diagnosis and treatment. Materials and Methods: Ten patients with apogeotropic PSC-BPPV underwent standard diagnostic and therapeutic maneuvers combined with ipsilateral 100 Hz mastoid vibration. The primary outcome was the rate of nystagmus geotropization. Secondary outcomes included the number of repositioning maneuvers required to achieve complete symptom resolution. Outcomes were compared with those of two control groups: one consisting of patients with apogeotropic PSC-BPPV treated without mastoid vibration and another consisting of patients with typical PSC-BPPV treated using standard repositioning maneuvers alone. Results: Mastoid vibration induced geotropization in 7 out of 10 patients (70%). The mean number of liberatory maneuvers required for symptom resolution was lower in vibration-responsive patients than in vibration-non-responsive patients (1.7 ± 0.49 vs. 3.0 ± 1.41;). Compared with patients with apogeotropic PSC-BPPV treated without mastoid vibration, vibration-responsive patients required significantly fewer maneuvers (2.1 ± 0.87 vs. 2.9 ± 0.74; p = 0.036). No significant difference was observed when compared with patients with typical PSC-BPPV (2.1 ± 0.87 vs. 2.1 ± 0.52; p = 0.82). Conclusions: Mastoid vibration may represent a useful adjunctive tool in the management of apogeotropic PSC-BPPV by facilitating conversion to the typical geotropic pattern. This conversion may provide useful diagnostic information, and potentially reduce the number of repositioning maneuvers required to achieve symptom resolution.