Unilateral posterior canal-plugging surgery for intractable bilateral posterior canal-type benign paroxysmal positional vertigo

Sayaka Hotta; Takao Imai; Kayoko Higashi-Shingai; Suzuyo Okazaki; Tomoko Okumura; Atsuhiko Uno; Yumi Ohta; Tetsuo Morihana; Takashi Sato; Hidenori Inohara

doi:10.1016/j.anl.2016.11.010

Unilateral posterior canal-plugging surgery for intractable bilateral posterior canal-type benign paroxysmal positional vertigo

Auris Nasus Larynx. 2017 Oct;44(5):540-547. doi: 10.1016/j.anl.2016.11.010. Epub 2016 Dec 12.

Authors

Affiliations

¹ Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan.
² Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan. Electronic address: timai@ent.med.osaka-u.ac.jp.
³ Department of Otolaryngology, Suita Municipal Hospital, 2-13-20 Katayama-cho, Suita-shi, Osaka 564-0082, Japan.
⁴ Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, 3-1-56 Mandai-higashi, Sumiyoshi-ku, Osaka-shi, Osaka 558-8558, Japan.
⁵ Department of Otorhinolaryngology, National Hospital Organization Osaka National Hospital, 2-1-14 Houenzaka, Tyuo-ku, Osaka-shi, Osaka 540-0006, Japan.

PMID: 27979611
DOI: 10.1016/j.anl.2016.11.010

Abstract

Objective: To investigate the effectiveness of unilateral posterior semicircular canal (PSCC)-plugging surgery for patients with intractable bilateral PSCC-type benign paroxysmal positional vertigo (P-BPPV).

Methods: From July 2011 to December 2015, we diagnosed 136 patients with P-BPPV. Of these, 3 patients had bilateral P-BPPV, and in 2 of the 3, the condition had been refractory to conservative treatment for more than 1 year. We planned a staged PSCC-plugging surgery for these 2 patients; initially one side was treated, and the contralateral side was treated 6 months later.

Results: After the first surgery, both patients experienced improvement in symptoms of vertigo and nystagmus on the operated side and no change on the non-operated side. Patients underwent the Epley maneuver for the non-operated side. In one case, the non-operated side was cured. In the other case, although the P-BPPV was not completely resolved, the patient was satisfied with the result of unilateral surgery because he was now able to turn in bed to the operated side without vertigo. Before surgery, he had experienced vertigo when turning even slightly in bed.

Conclusion: We propose that even unilateral PSCC-plugging surgery is effective for some patients with intractable bilateral P-BPPV.

Keywords: Bilateral; Canalolithiasis; Plugging surgery; Rotation vector; Three-dimensional.

MeSH terms

Aged
Aged, 80 and over
Benign Paroxysmal Positional Vertigo / surgery*
Female
Humans
Male
Nystagmus, Pathologic / surgery
Otologic Surgical Procedures / methods*
Patient Satisfaction
Semicircular Canals / surgery*
Therapeutic Occlusion*