Causes of Persistent Positional Vertigo Following Posterior Semicircular Canal Occlusion for Benign Paroxysmal Positional Vertigo
| Autor: | Christopher A. Schutt, Seilesh Babu, John J. Zappia, Eric W. Sargent, Alexander L. Luryi, Michael J. LaRouere, Dennis I. Bojrab |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Benign paroxysmal positional vertigo Adolescent Hearing loss Young Adult 03 medical and health sciences 0302 clinical medicine Recurrence Otology Occlusion otorhinolaryngologic diseases medicine Humans Benign Paroxysmal Positional Vertigo 030223 otorhinolaryngology Aged Retrospective Studies Aged 80 and over Palsy Cerebrospinal fluid leak business.industry Posterior Semicircular Canal Middle Aged medicine.disease Semicircular Canals Sensory Systems Surgery Treatment Outcome Otorhinolaryngology Otologic Surgical Procedures Female sense organs Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Otology & Neurotology. 39:e1078-e1083 |
| ISSN: | 1537-4505 1531-7129 |
| Popis: | Objective To report causes of persistent recalcitrant positional vertigo (PRPV) after posterior semicircular canal occlusion (PSCO) for benign paroxysmal positional vertigo (BPPV). Study design Retrospective chart review. Setting Single high-volume otology practice. Patients Patients diagnosed with BPPV from 2007 to 2017. Intervention PSCO and follow-up care including diagnostic and particle repositioning maneuvers for recurrent BPPV. Main outcome measures PRPV, defined as recalcitrant positional vertigo for any reason following PSCO. Results Twenty seven PSCO operations were performed in 26 patients. Twenty five patients (96.2%) had resolution of the Dix-Hallpike test in the operated ear. Eleven patients (42.3%) developed BPPV postoperatively, three (11.5%) in the operated ear and eight (30.8%) in the contralateral ear. Five of eight patients (62.5%) who developed contralateral BPPV had unilateral BPPV preoperatively. Eight patients (30.8%) developed BPPV at least twice after surgery or did not resolve, qualifying as PRPV, and all but one of these events occurred in the nonsurgical ear. No instances of cerebrospinal fluid leak, postoperative infection, facial palsy, clinically significant hearing loss, or death occurred. Conclusions PSCO is a safe and effective option for recalcitrant BPPV. However, 30.8% of patients, including patients with initially unilateral BPPV, had recalcitrant positional vertigo postoperatively, usually due to contralateral BPPV. Patients considering PSCO should be counseled regarding this risk to ensure realistic expectations. |
| Databáze: | OpenAIRE |
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