Posterior Semi-Circular Canal Occlusion Surgery for Intractable BPPV

The objective of this study was to assess the long-term efficacy and safety of posterior semicircular canal (PSCC) occlusion for intractable and incapacitating benign positional vertigo (BPPV). 45 PSCC occlusion procedures were performed at the University Health Network, Toronto, between 1998 and 2013 (36 female, 9 male). All patients had complete resolution of their PSCC BPPV, which has been maintained in the long-term. 13 patients (29%) have experienced other forms of dizziness post-operatively (contralateral BPPV in 4, continued Ménière’s attacks in 3, ipsilateral lateral or superior canal BPPV in 4, otolithic symptoms in 2, continued oscillopsia in 1 with subsequent cerebellar degeneration). There were no cases of significant hearing loss. 5 patients had a mild to moderate reduction in caloric activity in the operated ear post-operatively. 2 patients with Ménière’s disease had a significant post-operative caloric reduction. No patient had post-operative facial weakness. PSCC occlusion is a safe and highly effective treatment for intractable BPPV. However, other forms of vertigo may persist or arise subsequently in approximately 40% of cases. Patients with Ménière’s disease may be susceptible to increased caloric reduction post-operatively.