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Posterior semicircular canal occlusion for intractable benign positional vertigo: outcome in 55 ears in 53 patients operated upon over 20 years

Published online by Cambridge University Press:  15 May 2012

R M Ahmed ,
D V Pohl ,
H G MacDougall ,
T Makeham  and
G M Halmagyi
R M Ahmed
Affiliation:
Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia
D V Pohl
Affiliation:
Department of Otorhinolaryngology, Royal Prince Alfred Hospital, Sydney, Australia
H G MacDougall
Affiliation:
Vestibular Research Laboratory, School of Psychology, University of Sydney, New South Wales, Australia
T Makeham
Affiliation:
Department of Otorhinolaryngology, Royal Prince Alfred Hospital, Sydney, Australia
G M Halmagyi*
Affiliation:
Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia
*
Address for correspondence: Dr G M Halmagyi, Department of Neurology, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, Australia 2050 Fax: +61 2 9515 7564 E-mail: gmh@icn.usyd.edu.au
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Abstract

Objective:

To report the outcome of posterior semicircular canal occlusion surgery for intractable benign positional vertigo, regarding vertigo cure rate and hearing and balance outcomes.

Methods:

Retrospective review of 53 patients presenting with benign positional vertigo, unresponsive to repositioning manoeuvres, who eventually underwent posterior canal occlusion, over a 20 year period.

Results:

From 1991 to 2011, 5364 benign positional vertigo patients were treated in our balance disorders clinic; 53 of those who failed to respond to repositioning underwent posterior canal occlusion. All 53 were cured of their benign positional vertigo. Nine suffered some symptomatic permanent hearing loss (>20 dB at low and >25 dB at high frequencies). Ten patients suffered caloric vestibular function deterioration, with mild but permanent subjective imbalance in five; a further 10 patients with no post-operative caloric test changes also had some permanent imbalance. Benign positional vertigo later developed in the operated ear lateral canal in two patients and in the opposite ear posterior canal in eight patients. Two patients needed bilateral sequential posterior canal occlusion.

Conclusion:

Posterior canal occlusion is a highly effective treatment for intractable benign positional vertigo, with what is probably an acceptable risk to hearing and balance: five of six patients will have no hearing problem and nine of 10 no balance problem after surgery.

Keywords

Ear, InnerBenign Positional VertigoOtologic Surgical Procedure
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 7 , July 2012 , pp. 677 - 682
Copyright
Copyright © JLO (1984) Limited 2012

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