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

Published online by Cambridge University Press:  31 October 2019

F Hassannia ,
P Douglas-Jones  and
J A Rutka
F Hassannia*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Toronto General Hospital, University Health Network, University of Toronto, Canada
P Douglas-Jones
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Toronto General Hospital, University Health Network, University of Toronto, Canada
J A Rutka
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Toronto General Hospital, University Health Network, University of Toronto, Canada
*
Author for correspondence: Dr Fatemeh Hassannia, Department of Otolaryngology – Head and Neck Surgery, Toronto General Hospital, University Health Network, 8N Room 873, 200 Elizabeth Street, Toronto M5G 2C4, Canada E-mail: [email protected] Fax: +1 416 340 327
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Abstract

Background

Transmastoid 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.

Methods

This 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.

Results

Post-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.

Conclusion

Transmastoid 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.

Keywords

Canal OcclusionTransmastoidBenign Paroxysmal Positional VertigoSemicircular CanalsSuperior Semicircular Canal Dehiscence Syndrome
Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 11 , November 2019 , pp. 1012 - 1016
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr F Hassannia takes responsibility for the integrity of the content of the paper

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