Document Detail

Surgical therapy in intractable benign paroxysmal positional vertigo.
MedLine Citation:
PMID:  17478200     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) is the most frequent vestibular disorder. Although it is easily cured with canal repositioning maneuvers for the majority of patients, it can be disabling in rare cases. For these patients, surgical solutions may be proposed. The aim of this article is to review the techniques used, the reported cases in the literature, and to discuss their indication in intractable BPPV. STUDY DESIGN: Literature review. MATERIALS AND METHODS: All the articles from 1972 to 2005 that discussed a specific surgical therapy in BPPV were reviewed. Many of them reported cases of operated patients and described original techniques. Some others are anatomic studies that discussed the two techniques used: singular neurectomy and posterior semicircular canal occlusion. RESULTS: Singular neurectomy (posterior ampullary nerve transsection) and posterior semicircular canal occlusion are the 2 specific techniques used in intractable BPPV surgery. The numbers of operated cases are 342 and 97, respectively. These small numbers indicate that the procedures are difficult and risk compromising hearing and that a very small population of patients require surgical treatment of BPPV. The operated cases have been decreasing since the early 1990s because of improved management in BPPV. This article summarizes the techniques and their results and proposes a currently recommended practice of surgical therapy in BPPV as well as new insights into intractable BPPVs' physiopathology.
Marianne Leveque; Marc Labrousse; Laurent Seidermann; André Chays
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery     Volume:  136     ISSN:  0194-5998     ISO Abbreviation:  Otolaryngol Head Neck Surg     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-04     Completed Date:  2007-06-21     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8508176     Medline TA:  Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  693-8     Citation Subset:  IM    
Department of ENT, Robert Debre Hospital, CHU Reims, France.
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MeSH Terms
Hearing Loss, Sensorineural / prevention & control
Otologic Surgical Procedures / methods*
Postural Balance / physiology*
Semicircular Canals / physiopathology,  surgery
Vertigo / physiopathology*,  surgery*
Vestibular Nerve / surgery

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