Long-term results of posterior semicircular canal occlusion for intractable benign paroxysmal positional vertigo.

Benign paroxysmal positional vertigo (BPPV) is a common condition which is usually managed conservatively, surgical intervention being recommended only for those small number of patients in whom it becomes persistent and incapacitating. The results of surgery in 13 patients who underwent posterior semicircular canal occlusion for intractable (> 12 months duration) and incapacitating BPPV are presented with special emphasis on their long-term follow-up. The mean follow-up was 66 months (range, 29-119 months). All patients reported complete and immediate resolution of their positional vertigo, which has been maintained in the long term. Most patients, however, reported some postoperative transient unsteadiness which lasted up to 4 weeks. All patients developed a transient mild conductive hearing loss secondary to a middle ear collection, which usually resolved within 4 weeks. Five patients developed a transient mild high frequency sensorineural hearing loss which resolved in all cases within 6 months. There were no reports of sensorineural hearing loss nor tinnitus in the long term. All patients believed that the operation was beneficial and would undergo it again. Our findings indicate that posterior semicircular canal occlusion is an effective and safe operation in the long term and is the procedure of choice for intractable and incapacitating BPPV rather than singular neurectomy.