Successful Resolution of Short-arm Posterior Semicircular Canalolithiasis Using an Adaptive Prone Pitch and Yaw Maneuver

Abstract Background and Introduction: Short-arm posterior semicircular canal (PSC) canalolithiasis is an uncommon but increasingly recognized variant of benign paroxysmal positional vertigo (BPPV), often overlooked due to atypical oculomotor findings. Objective: The objective of the study is to describe a case of short-arm PSC-BPPV successfully treated with an adapted prone pitch and yaw maneuver (PPYM). Case Description: A 51-year-old male presented with acute vertigo, nausea, and retropulsion on sitting up, without classical Dix–Hallpike test (DHT) findings. A left half-DHT elicited prolonged torsional upbeating nystagmus, consistent with short-arm PSC canalolithiasis. Results/Outcome: Following a single PPYM, the patient experienced complete resolution of vertigo and negative positional tests within 4 h. Conclusions: This case highlights the importance of recognizing short-arm PSC-BPPV and demonstrates the efficacy of a simple, accessible therapeutic maneuver.