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Laryngoscope. 2016 Sep;126(9):2092-7. doi: 10.1002/lary.25797. Epub 2015 Dec 15.

Benign paroxysmal positional vertigo commonly occurs following repair of superior canal dehiscence.

Author information

1
Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.
2
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.

Abstract

OBJECTIVES/HYPOTHESIS:

Repair of superior canal dehiscence (SCD) often results in the resolution of preoperative auditory and vestibular symptoms; however, many patients experience dizziness in the postoperative period. Postoperative dizziness may be the result of new-onset benign paroxysmal positional vertigo (BPPV). This study aims to investigate the prevalence of BPPV before and following SCD repair.

STUDY DESIGN:

Retrospective chart review at a tertiary care center.

METHODS:

Electronic medical records were reviewed for patients with a diagnosis of SCD syndrome (SCDS) between January 2002 and May 2015. Collected information included demographic data, incidence of BPPV diagnosed by Dix-Hallpike maneuver before and following surgery, operative technique, repair material, and the duration of time to BPPV onset.

RESULTS:

A total of 180 patients with a diagnosis of SCDS were identified: 84 patients underwent surgery (operated subjects) and 96 were observed (nonoperated, control group). In operated subjects, 20 of 84 (23.8%) developed BPPV following SCD repair versus 6.2% of nonoperated (P < 0.005). Benign paroxysmal positional vertigo lateralized to the operated side in all but one subject whose laterality was unknown (P < 0.0001). There were no associations of BPPV with surgical approach (P = 0.50) or repair material (P = 0.33). The majority of subjects (58%) were diagnosed with BPPV within 3 months of surgery.

CONCLUSION:

New-onset BPPV occurs commonly after SCD repair and may be the result of mobilized otoliths from inner ear pressure changes. Although the exact etiology of post-SCD repair BPPV remains unknown, postoperative dizziness is important to discuss with patients during preoperative counseling.

LEVEL OF EVIDENCE:

4. Laryngoscope, 126:2092-2097, 2016.

KEYWORDS:

Benign paroxysmal positional vertigo; dizziness; outcomes; plugging; resurfacing; superior canal dehiscence; superior canal dehiscence syndrome; surgery

PMID:
26666775
DOI:
10.1002/lary.25797
[Indexed for MEDLINE]

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