Unexpected complication of posterior canal occlusion surgery for benign paroxysmal positional vertigo.
OBJECTIVE
The purpose of this report was to illustrate how an unusual complication of posterior canal occlusion surgery for benign paroxysmal positional vertigo (BPPV) may be recognized and prevented. Recurrence of BPPV after occlusion surgery of the posterior semicircular canal has not previously been reported in the literature, to the authors' knowledge. Failure of occlusion not only permits the continued symptoms of BPPV but also burdens the patient with the additional morbidity of a fistula of the PSCC. The authors describe the successful treatment of a patient with recurrent and incapacitating BPPV after the failure of occlusion surgery of the posterior semicircular canal, when the patient was simultaneously crippled by the distressing morbidity of an iatrogenic fistula.


METHODS
Case report.


METHODS
Tertiary care referral center.


METHODS
Surgical excision of the fistulous segment of the membranous posterior semicircular canal.


METHODS
The BPPV was resolved. The distressing symptom of a fistula was eliminated. Hearing was preserved.


CONCLUSIONS
Failure to completely occlude the posterior semicircular canal during posterior canal occlusion surgery results in recurrence of BPPV and an iatrogenic fistula, both of which are preventable. The occurrence of such an event is described, its management is outlined, and some thoughts are offered about its prevention.
Rizvi
Syed S
SS
Department of Otolaryngology and Head and Neck Surgery, Bay Medical Center, Bay City, Michigan, USA. ssrizvi@chartermi.net
Gauthier
Marie G
MG
D004584:Electronystagmography; D005402:Fistula / Q000175:diagnosis / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007759:Labyrinth Diseases / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*; D012086:Reoperation; D012665:Semicircular Canals / Q000473:pathology / Q000601:surgery*; D013069:Speech Reception Threshold Test; D013529:Surgical Wound Dehiscence / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014717:Vertigo / Q000175:diagnosis / Q000601:surgery*; D014724:Vestibular Function Tests