Laryngorhinootologie 2007; 86(7): 484-489
DOI: 10.1055/s-2007-980317
Tipps & Tricks

© Georg Thieme Verlag KG Stuttgart · New York

Okklusion des posterioren Bogengangs bei therapieresistentem benignem paroxysmalem Lagerungsschwindel (BPLS)

Occlusion of the Posterior Semicircular CanalProf. Martin Westhofen
Further Information

Publication History

Publication Date:
27 June 2007 (online)

 

Abstract

The majority of patients with benign paroxysmal positional vertigo of the posterior semicircular canal (p-BPPV) can be treated by means of Brandt-Daroff's habituation, Semont's liberating and Epley's repositioning manoevers. Persistence or short term recurrence of symptoms is rarely observed. Non-responders have to be evaluated because the involvement of the contralateral superior semicircular canal or of the ipsilateral horizontal canal has to be excluded. Persistence of the intensity and duration of the nystagmus responses in repetitive Dix-Hallpike manoevers can indicate other types of positional vertigo. For non-responders on positional treatment procedures the occlusion of the posterior semicircular canal is indicated. To provide minimal-invasive procedure and to secure permanent occlusion of the canal lumen the combination of fascia and hydroxylapatite is recommended. Surgical procedure and follow-up by means of DHI, 3D-MRI and Dix-Hallpike manoever are demonstrated.

Literatur

  • 01 Mizukoshi K . Watanabe Y . Shojaku H . Okubo J . Epidemiological studies on benign paroxysmal positional vertigo in Japan.  Acta Otolaryngol Suppl. 1998;  447 67-72
  • 02 Gordon CR . Levite R . Joffe V . Gadoth N . Is posttraumatic benign paroxysmal positional vertigo different from the idiopathic form?.  Arch Neurol. 2004;  61 1590-1593
  • 03 Uneri A . Migraine and benign paroxysmal positional vertigo: an outcome study of 476 patients.  Ear Nose Throat J. 2004;  83 814-815
  • 04 Katsarkas A . Benign paroxysmal positional vertigo (BPPV): idiopathic versus post-traumatic.  Acta Otolaryngol. 1999;  119 745-749
  • 05 Beynon GJ . Baguley DM . da Cruz MJ . Recurrence of symptoms following treatment of posterior semicircular canal benign positional paroxysmal vertigo with a particle repositioning manoeuvre.  J Otolaryngol. 2000;  29 2-6
  • 06 Epley JM . Human Experience with Canalith Repositioning Maneuvers.  Ann N Y Acad Sci. 2001;  942 179-191
  • 07 Mosca F . Morano M . Benign paroxysmal positional vertigo, incidence and treatment.  Ann Otolaryngol Chir Cervicofac. 2001;  118 95-101
  • 08 Otsuka K . Suzuki M . Furuya M . Model experiment of benign paroxysmal positional vertigo mechanism using the whole membranous labyrinth.  Acta Otolaryngol. 2003;  123 515-518
  • 09 Takaya S . Yamamoto T . Horizontal canal benign paroxysmal positional vertigo (HC-BPPV) with direction-changing apogeotropic nystagmus: a case with the more-triggering side altering over a short-term.  No To Shinkei. 2002;  54 321-325
  • 10 Rapoport A . Sadeh M . Posterior semicircular canal type benign paroxysmal positioning vertigo with ageotropic paroxysmal positioning nystagmus.  Audiol Neurootol. 2001;  6 50-53
  • 11 Steenerson RL . Cronin GW . Marbach PM . Effectiveness of treatment techniques in 923 cases of benign paroxysmal positional vertigo.  Laryngoscope. 2005;  115 226-231
  • 12 Sakaida M . Takeuchi K . Ishinaga H . Adachi M . Majima Y . Long-term outcome of benign paroxysmal positional vertigo.  Neurology. 2003;  60 1532-1534
  • 13 Soto VA . Bartual MJ . Santos PS . et al . Benign paroxysmal vertigo: a comparative prospective study of the efficacy of Brandt and Daroff exercises, Semont and Epley maneuver.  Rev Laryngol Otol Rhinol (Bord). 2001;  122 179-183
  • 14 Simhadri S . Panda N . Raghunathan M . Efficacy of particle repositioning maneuver in BPPV: a prospective study.  Am J Otolaryngol. 2003;  24 355-360
  • 15 Monobe H . Sugasawa K . Murofushi T . The outcome of the canalith repositioning procedure for benign paroxysmal positional vertigo: are there any characteristic features of treatment failure cases?.  Acta Otolaryngol Suppl. 2001;  545 38-40
  • 16 Macias JD . Lambert KM . Massingale S . Ellensohn A . Fritz JA . Variables affecting treatment in benign paroxysmal positional vertigo.  Laryngoscope. 2000;  110 1921-1924
  • 17 Del Rio M . Arriaga MA . Benign positional vertigo: prognostic factors.  Otolaryngol Head Neck Surg. 2004;  130 426-429
  • 18 Macias JD . Lambert KM . Massingale S . Ellensohn A . Fritz JA . Variables affecting treatment in benign paroxysmal positional vertigo.  Laryngoscope. 2000;  110 1921-1924
  • 19 Gordon CR . Gadoth N . Repeated vs single physical maneuver in benign paroxysmal positional vertigo.  Acta Neurol Scand. 2004;  110 166-169
  • 20 Sherman D . Massoud EA . Treatment outcomes of benign paroxysmal positional vertigo.  J Otolaryngol. 2001;  30 295-299
  • 21 Parnes LS . Agrawal SK . Atlas J . Diagnosis and management of benign paroxysmal positional vertigo (BPPV).  CMAJ. 2003;  169 681-693
  • 22 Parnes LS . McClure JA . Posterior semicircular canal occlusion for intractable benign paroxysmal positional vertigo.  Ann Otol Rhinol Laryngol. 1990;  99 330-334
  • 23 Agrawal SK . Parnes LS . Human experience with canal plugging.  Ann N Y Acad Sci. 2001;  942 300-305
  • 24 Jacobson GP . Calder JH . A screening version of the Dizziness Handicap Inventory (DHI-S).  Am J Otol. 1998;  19 804-808
  • 25 Krombach GA . Schmitz-Rode T . Tacke J . et aL . Magnetic resonance tomography imaging of the inner ear of patients with sensorineural hearing loss or vertigo.  Laryngo-Rhino-Otol. 2001;  80 177-181
  • 26 Antonelli PJ . Lundy LB . Kartush JM . Burgio DL . Graham MD . Mechanical versus CO2 laser occlusion of the posterior semicircular canal in humans.  Am J Otol. 1996;  17 416-420
  • 27 Parnes LS . Update on posterior canal occlusion for benign paroxysmal positional vertigo.  Otolaryngol Clin North Am. 1996;  29 333-342
  • 28 Hawthorne M . el Naggar M . Fenestration and occlusion of posterior semicircular canal for patients with intractable benign paroxysmal positional vertigo.  J Laryngol Otol. 1994;  108 935-939
  • 29 Antonelli PJ . Lundy LB . Kartush JM . Burgio DL . Graham MD . Mechanical versus CO2 laser occlusion of the posterior semicircular canal in humans.  Am J Otol. 1996;  17 416-420
  • 30 Kartush JM . Sargent EW . Posterior semicircular canal occlusion for benign paroxysmal positional vertigo - CO2 laser-assisted technique: preliminary results.  Laryngoscope. 1995;  105 268-274
  • 31 Jacobson GP . Calder JH . A screening version of the Dizziness Handicap Inventory (DHI-S).  Am J Otol. 1998;  19 804-808
  • 32 Schmal F . Stoll W . Diagnosis and management of benign paroxysmal positional vertigo.  Laryngo-Rhino-Otol. 2002;  81 368-380
  • 33 Rahko T . The test and treatment methods of benign paroxysmal positional vertigo and an addition to the management of vertigo due to the superior vestibular canal (BPPV-SC).  Clin Otolaryngol. 2002;  27 392-395
  • 34 Beynon GJ . Baguley DM . Moffat DA . Irving RM . Positional vertigo as a first symptom of a cerebellopontine angle cholesteatoma: case report.  Ear Nose Throat J. 2000;  79 508-510
  • 35 Motamed M . Osinubi O . Cook JA . Effect of mastoid oscillation on the outcome of the canalith repositioning procedure.  Laryngoscope. 2004;  114 1296-1298
  • 36 Hain TC . Helminski JO . Reis IL . Uddin MK . Vibration does not improve results of the canalith repositioning procedure.  Arch Otolaryngol Head Neck Surg. 2000;  126 617-622
  • 37 Gordon CR . Gadoth N . Repeated vs single physical maneuver in benign paroxysmal positional vertigo.  Acta Neurol Scand. 2004;  110 166-169
  • 38 Del Rio M . Arriaga MA . Benign positional vertigo: prognostic factors.  Otolaryngol Head Neck Surg. 2004;  130 426-429
  • 39 Sakaida M . Takeuchi K . Ishinaga H . Adachi M . Majima Y . Long-term outcome of benign paroxysmal positional vertigo.  Neurology. 2003;  60 1532-1534
  • 40 Beynon GJ . A review of management of benign paroxysmal positional vertigo by exercise therapy and by repositioning manoeuvres.  Br J Audiol. 1997;  31 11-26
  • 41 Beynon GJ . Baguley DM . da Cruz MJ .   . Recurrence of symptoms following treatment of posterior semicircular canal benign positional paroxysmal vertigo with a particle repositioning manoeuvre.  J Otolaryngol. 2000;  29 2-6
  • 42 Walsh RM . Bath AP . Cullen JR . Rutka JA . Long-term results of posterior semicircular canal occlusion for intractable benign paroxysmal positional vertigo.  Clin Otolaryngol. 1999;  24 316-323
  • 43 Parnes LS . Update on posterior canal occlusion for benign paroxysmal positional vertigo.  Otolaryngol Clin North Am. 1996;  29 333-342
  • 44 Walsh RM . Bath AP . Cullen JR . Rutka JA . Long-term results of posterior semicircular canal occlusion for intractable benign paroxysmal positional vertigo.  Clin Otolaryngol. 1999;  24 316-323
  • 45 Beynon GJ . Baguley DM . da Cruz MJ . Recurrence of symptoms following treatment of posterior semicircular canal benign positional paroxysmal vertigo with a particle repositioning manoeuvre.  J Otolaryngol. 2000;  29 2-6
  • 46 Mosca F . Morano M . Benign paroxysmal positional vertigo, incidence and treatment.  Ann Otolaryngol Chir Cervicofac. 2001;  118 95-101
  • 47 Ferri E . Morano M . Treatment approaches to benign paroxysmal positional vertigo. Clinical features in 228 cases of posterior and lateral canalolithiasis.  Acta Otorhinolaryngol Ital. 1999;  19 12-20
  • 48 Uno A . Nagai M . Sakata Y . Moriwaki K . Kato T . Statistical observation of vertigo and dizziness patients.  Nippon Jibiinkoka Gakkai Kaiho. 2001;  104 1119-1125
  • 49 Motamed M . Osinubi O . Cook JA . Effect of mastoid oscillation on the outcome of the canalith repositioning procedure.  Laryngoscope. 2004;  114 1296-1298
  • 50 Hain TC . Helminski JO . Reis IL . Uddin ML . Vibration does not improve results of the canalith repositioning procedure.  Arch Otolaryngol Head Neck Surg. 2000;  126 617-622
  • 51 Gordon CR . Gadoth N . Repeated vs single physical maneuver in benign paroxysmal positional vertigo.  Acta Neurol Scand. 2004;  110 166-169
  • 52 Del Rio M . Arriaga MA . Benign positional vertigo: prognostic factors.  Otolaryngol Head Neck Surg. 2004;  130 426-429
  • 53 Sakaida M . Takeuchi K . Ishinaga H . Adachi M . Majima Y . Long-term outcome of benign paroxysmal positional vertigo.  Neurology. 2003;  60 1532-1534
  • 54 Beynon GJ . A review of management of benign paroxysmal positional vertigo by exercise therapy and by repositioning manoeuvres.  Br J Audiol. 1997;  31 11-26
  • 55 Beynon GJ . Baguley DM . da Cruz MJ . Recurrence of symptoms following treatment of posterior semicircular canal benign positional paroxysmal vertigo with a particle repositioning manoeuvre.  J Otolaryngol. 2000;  29 2-6
  • 56 Walsh RM . Bath AP . Cullen JR . Rutka JA . Long-term results of posterior semicircular canal occlusion for intractable benign paroxysmal positional vertigo.  Clin Otolaryngol. 1999;  24 316-323
  • 57 Parnes LS . Update on posterior canal occlusion for benign paroxysmal positional vertigo.  Otolaryngol Clin North Am. 1996;  29 333-342
  • 58 Walsh RM . Bath AP . Cullen JR . Rutka JA . Long-term results of posterior semicircular canal occlusion for intractable benign paroxysmal positional vertigo.  Clin Otolaryngol. 1999;  24 316-323
  • 59 Beynon GJ . Baguley DM . da Cruz MJ . Recurrence of symptoms following treatment of posterior semicircular canal benign positional paroxysmal vertigo with a particle repositioning manoeuvre.  J Otolaryngol. 2000;  29 2-6
  • 60 Mosca F . Morano M . Benign paroxysmal positional vertigo, incidence and treatment.  Ann Otolaryngol Chir Cervicofac. 2001;  118 95-101
  • 61 Ferri E . Armato E . Ianniello F . Treatment approaches to benign paroxysmal positional vertigo. Clinical features in 228 cases of posterior and lateral canalolithiasis.  Acta Otorhinolaryngol Ital. 1999;  19 12-20
  • 62 Uno A . Nagai M . Sakata Y . Moriwaki K . Kato T . Statistical observation of vertigo and dizziness patients.  Nippon Jibiinkoka Gakkai Kaiho. 2001;  104 1119-1125
    >