Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-08T07:22:32.276Z Has data issue: false hasContentIssue false

Fenestration and occlusion of posterior semicircular canal for patients with intractable benign paroxysmal positional vertigo

Published online by Cambridge University Press:  29 June 2007

Maurice Hawthorne*
Affiliation:
Department of Otolaryngology, North Riding Infirmary, Middlesbrough, Cleveland.
Mohamed El-Naggar
Affiliation:
Department of Otolaryngology, North Riding Infirmary, Middlesbrough, Cleveland.
*
Mr M. Hawthorne, F.R.C.S., ENT Consultant, North Riding Infirmary, Newport Road, Middlesbrough, Cleveland TS1 5JE.

Abstract

A series of 15 patients with intractable benign paroxysmal positional vertigo (BPPV) who had fenestration and occlusion of the posterior semicircular canal (FOP) surgery commencing in December 1990 are reported. Follow-up was from 14 to 40 months. All patients reported a cure of their positional vertigo. No patient regretted having the surgery. All patients had a negative Dix-Hallpike test post-operatively and the test remained negative for the duration of follow-up. Eight patients had a mild high frequency sensorineural hearing (SNHL) loss post-operatively which had almost recovered six months later. No patient reported any change in their hearing following surgery. Of the 10 patients who did not have pre-operative tinnitus, developed tinnitus but it was not considered significant by them. All patients developed mild unsteadiness following surgery which gradually improved with mobilization and physiotherapy if necessary.

The operation preserves hearing, is technically straightforward, well-tolerated and effective.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anthony, P. F. (1993) Partitioning the labyrinth for benign paroxysmal positional vertigo: clinical and histologic findings. American Journal of Otology 14: 334342.Google ScholarPubMed
Brandt, T., Daroff, R. B. (1980) Physical therapy for benign paroxysmal positional vertigo. Archives of Otolaryngoloqy 106: 484485.CrossRefGoogle ScholarPubMed
Dingle, A. F, Hawthorne, M., Kumar, B. (1992) Fenestration and occlusion of posterior semicircular canal. Clinical Otolaryngology 17: 300302.CrossRefGoogle ScholarPubMed
Dix, M. R., Hallpike, C. S. (1952) The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Proceedings of the Royal Society of Medicine 45: 341354.CrossRefGoogle ScholarPubMed
Fluur, E., Siegborn, J. (1974) Interaction between the utricle and the vertical semicircular canals. Acta Otolaryngologica 77: 8085.CrossRefGoogle ScholarPubMed
Gacek, R. R. (1974) Transection of the posterior ampullary nerve for relief of benign paroxysmal positional vertigo. Annals of Otology, Rhinology and Laryngology 83: 596605.CrossRefGoogle ScholarPubMed
Gacek, R. R. (1982) Singular neurectomy update. Annals of Otology, Rhinology and Laryngology 91: 469473.CrossRefGoogle ScholarPubMed
Gacek, R. R. (1984) Cupulolithiasis and posterior ampullary nerve transection. Annals of Otology, Rhinology and Laryngology 93 (Supp. 112): 2531.CrossRefGoogle Scholar
Gacek, R. R. (1991) Singular neurectomy update II. Laryngoscope 101: 855862.CrossRefGoogle ScholarPubMed
Gibson, W. P. R. (1988) Vestibular diagnostic tests. In Otologic Medicine and Surgery. Vol. 1. ch. 17. (Alberti, P. W., Ruben, R. J., eds.), Churchill-Livingstone, London, p 487.Google Scholar
Hall, S. F, Ruby, R. E, McClure, J. A. (1979) The mechanics of benign paroxysmal vertigo. Journal of Otolaryngology 8: 151158.Google ScholarPubMed
Hawthorne, M. R. (1992) Fenestration and occlusion of posterior semicircular canal for surgical management of intractable benign paroxysmal positional vertigo. Proceedings of the Second European Congress of Otorhinolaryngology(June)Sorrento, Italy.Google Scholar
Lome, S., Price-Jones, R. (1993) Particle reposition manoeuvre for benign paroxysmal positional vertigo. Annals of Otology, Rhinology and Laryngology 5: 102325.Google Scholar
Michaels, L. (1988) Pathology of inner ear. In Otologic Medicine and Surgery. Vol. 1. ch. 23. (Alberti, P. W., Ruben, R. J., eds.), Churchill-Livingstone, London, p 651.Google Scholar
Money, K. E., Scott, J. W. (1962) Functions of separate sensory receptors of nonauditory labyrinth of the cat. American Journal of Physiology 202: 121CrossRefGoogle ScholarPubMed
Moriarty, B., Rutka, J., Hawke, M. (1992) Incidence and distribution of cupular deposits in the labyrinth. Laryngoscope 102: 5659.CrossRefGoogle ScholarPubMed
Morrison, A. W. (1979) Diseases of the otic capsule–1: Otosclerosis. In Scott Brown's Diseases of the Ear, Nose and Throat. 4th Edition. Vol. 3. (Ballantyne, J. C, Groves, J., eds.), Butterworths, London, p 440.Google Scholar
Nedzelski, J. M., Barber, H. O., Mcllmoyl, L. (1986) Diagnosis in dizziness unit. Journal of Otolaryngology 15: 101104.Google ScholarPubMed
Ohmici, T., Rutka, J., Hawke, M. (1989) Histopathologic consequences of surgical approaches to the singular nerve. Laryngoscope 99: 963970.CrossRefGoogle Scholar
Pace-Balzan, A., Rutka, J. (1991) Non-ampullary plugging of posterior semicircular canal for benign paroxysmal positional vertigo. Journal of Laryngology and Otology 105: 901906.CrossRefGoogle ScholarPubMed
Parnes, L. S., McClure, J. A. (1990) Posterior semicircular canal occlusion for intractable benign paroxysmal positional vertigo. Annals of Otology, Rhinology and Laryngology 99: 330334.CrossRefGoogle ScholarPubMed
Parnes, L. S., McClure, J. A. (1991) Posterior semicircular canal occlusion in the normal hearing ear. Otolaryngology-Head and Neck Surgery 104: 5257.CrossRefGoogle ScholarPubMed
Schuknecht, H. F. (1969) Cupulolithiasis. Archives of Otolaryngology 90: 113126.Google ScholarPubMed
Semont, A., Freys, G., Vitte, E. (1988) Curing the BPPV with a liberating manoeuvre. Advances in Otorhinolaryngology 42: 290293.Google Scholar