Nahm HJ, et al. - In a single tertiary referral center, researchers examined the subtype distribution of geriatric benign paroxysmal positional vertigo (BPPV) and compared the treatment efficiency according to the subtype of BPPV. Between March 2013 and March 2019, the consecutive 316 elderly patients diagnosed with BPPV were involved. The subtype of BPPV was determined using a head-roll and Dix-Hallpike tests. Of the 316 elderly patients with BPPV, 143 patients were diagnosed with posterior semicircular canal BPPV, 46 patients were diagnosed with the lateral semicircular canal (LSCC) canalolithiasis, 126 patients (40%) were diagnosed with LSCC cupulolithiasis, and 1 patient was diagnosed with anterior semicircular canal BPPV. The authors discovered that the proportion of LSCC cupulolithiasis in the elderly is higher, and the efficacy of canalith repositioning maneuver care in LSCC cupulolithiasis is lower than in other BPPV subtypes. High prevalence of LSCC cupulolithiasis may be explained by a lag between the initiation of BPPV and the presentation of the patient to the tertiary referral hospital or ageotropic positional nystagmus pathophysiology other than otoconial attachment to the LSCC cupula in elderly people.