Canal-Based Surgery: Does Surgery in the Vestibular Labyrinth Preserve its Functionality? Review of the Literature and Our Institutional Experience

Ishai, Reuven; Tsang, Gordon

doi:10.1007/s40136-017-0168-y

Cited by 2 publications

(3 citation statements)

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“…Although there are multiple reports in the literature commenting on the subjective improvement in symptoms and hearing outcomes following semicircular plugging in superior semicircular canal dehiscence syndrome, few discuss objective vestibular function post-operatively. 12…”

Section: Discussionmentioning

confidence: 99%

“…for recalcitrant bilateral BPPV or bilateral symptomatic superior semicircular canal dehiscence syndrome). 12,20 One suspects this is primarily the result of an element of central compensation, as well as the inherent redundancy in vertical canal function where unilateral occlusion has been performed, or the relative limited dynamic excursion comparatively seen in vertical versus horizontal head movements in bilateral canal occlusions.…”

Section: Discussionmentioning

confidence: 99%

“…9,10 There remains a paucity of quantifiable vestibular data in human subjects to support the subjective improvements reported. 11,12…”

Section: Introductionmentioning

confidence: 99%

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Gauging the effectiveness of canal occlusion surgery: how I do it

Hassannia

Douglas-Jones

2019

J. Laryngol. Otol.

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BackgroundTransmastoid occlusion of the posterior or superior semicircular canal is an effective and safe management option in patients with refractory benign paroxysmal positional vertigo or symptomatic superior semicircular canal dehiscence. A method of quantifying successful canal occlusion surgery is described.MethodsThis paper presents representative patients with intractable benign paroxysmal positional vertigo or symptomatic superior semicircular canal dehiscence, who underwent transmastoid occlusion of the posterior or superior semicircular canal respectively. Vestibular function was assessed pre- and post-operatively. The video head impulse test was included as a measure of semicircular canal and vestibulo-ocular reflex functions.ResultsPost-operative video head impulse testing showed reduced vestibulo-ocular reflex gain in occluded canals. Gain remained normal in the non-operated canals. Post-operative audiometry demonstrated no change in hearing in the benign paroxysmal positional vertigo patient and slight hearing improvement in the superior semicircular canal dehiscence syndrome patient.ConclusionTransmastoid occlusion of the posterior or superior semicircular canal is effective and safe for treating troublesome benign paroxysmal positional vertigo or symptomatic superior semicircular canal dehiscence. Post-operative video head impulse testing demonstrating a reduction in vestibulo-ocular reflex gain can reliably confirm successful occlusion of the canal and is a useful adjunct in post-operative evaluation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%