title: Surgical Treatment for Recurrent Benign Paroxysmal Positional Vertigo.
abstract: IntroductionBenign paroxysmal positional vertigo is a generally benign condition that responds to repositioning maneuvers and frequently resolves spontaneously. However, for some patients it can become a disabling condition in which surgery must be considered. Two different surgical techniques exist, singular neurectomy and posterior semicircular canal occlusion.ObjectiveThe objective of this study is to review the current status of singular nerve section and posterior semicircular canal occlusion as treatments for intractable benign paroxysmal positional vertigo, and to determine if there are published data available that favors one over the other.Data SourcesMEDLINE and OLDMEDLINE databases of the National Library of Medicine.Data SynthesisFour studies regarding singular neurectomy and 14 reports on semicircular canal occlusion were analyzed. Both techniques are reported to provide similar symptomatic benefit, with low risk of hearing loss and balance impairment. However, anatomical and clinical studies of singular neurectomy show it to be a more challenging technique, and considering that it is indicated in a very small number of cases, it may be difficult to master.ConclusionsBoth singular neurectomy and semicircular canal occlusion can be safe and effective in those few patients that require surgery for intractable positional vertigo. Although semicircular canal occlusion requires a postauricular transmastoid approach, it is ultimately easier to learn and perform adequately, and thus may be considered the best alternative.
authors.affiliation: Instituto Mexicano de Otología y Neurotología S.C., México, DF, Mexico.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Corvera Behar
authors.affiliation: Instituto Mexicano de Otología y Neurotología S.C., México, DF, Mexico; Department of Otolaryngology, Hospital General Dr. Manuel Gea González, México, DF, Mexico.
authors.forename: Miguel Alfredo
authors.initials: MA
authors.lastname: García de la Cruz
keywords: benign paroxysmal positional vertigo; otologic surgical procedures; semicircular canals; vertigo/surgery