Abstract
A 75-year-old man with incapacitating anterior canal benign paroxysmal positional vertigo (BPPV) was relieved of symptoms following anterior semicircular canal occlusion using a transmastoid approach. The preoperative symptoms were similar to those of posterior canal BPPV. The preoperative findings on Dix-Hallpike's maneuver were a paroxysmal torsional nystagmus with a down-beating component that increased when the patient's gaze was directed towards the affected ear. The most provoking head movement for the vertigo nystagmus was Dix-Hallpike's maneuver with the affected ear lowermost.