Key Points about Semicircular Canal Occlusion
- Semicircular canal occlusion is a treatment option for severe benign paroxysmal positional vertigo (BPPV).
- Complications associated with semicircular canal occlusion include infection, facial nerve damage, hearing loss, ringing in the ear, and balance issues.
- Your doctor will reconstruct the eardrum to help relieve symptoms of BPPV.
- Most patients experience relief from symptoms associated with positional vertigo after surgery.
- While some patients temporarily lose hearing, it will resolve gradually during the recovery period.
- When patients are chosen appropriately, the surgery successfully relieves the symptoms of BPPV.
Overview
Semicircular canal occlusion is a surgical treatment for benign paroxysmal positional vertigo (BPPV).
Surgery is an option after non-surgical treatments have failed. Approximately 5 percent of patients will need surgical treatment.
During the procedure, your doctor will make an incision behind the ear, perform a mastoidectomy, and remove the bone between the scalp and ear. The posterior semicircular canal is opened, and your doctor will reconstruct the eardrum.
Candidates for semicircular canal occlusion
Surgery may be an option for BPPV patients who have not found relief with particle-repositioning maneuvers, Brandt-Daroff exercises, or customized vestibular rehabilitation therapy.
Surgery is only appropriate for patients when the correct ear and affected canal have been identified. Generally, the procedure is indicated for the posterior semicircular canal. The risks of hearing loss might be greater if the procedure is used on other canals.
Risks associated with semicircular canal occlusion
While most people do not experience complications associated with semicircular canal occlusion, complications can occur. Complications may include:
- Bleeding
- Infection
- Dizziness
- Balance issues
- Hearing loss
- Ringing in the ear (tinnitus)
- Complications associated with the anesthesia
- Facial nerve injury
Preparing for semicircular canal occlusion
In preparation for semicircular canal occlusion, your doctor will outline what to expect before, during, and after surgery. Guidelines to ensure a successful surgery may include:
- Inform your doctor of all medications you are taking.
- Stop taking medications as instructed by your doctor at the specified time.
- Stop smoking.
- Arrange your home to remove any obstacles that may make it harder to move around with slight imbalances.
- Arrange to have someone who can drive you home after surgery and stay with you for a few days during recovery.
Expectations during semicircular canal occlusion
During the procedure, your ENT surgeon will make an incision behind the ear and will use a medical drill to open the mastoid bone. The balance canals live in the mastoid bone.
Your doctor will then create an opening in the bony posterior balance canal. A tissue graft is placed in the canal to prevent the symptoms of benign paroxysmal positional vertigo. Small bone chips are then placed over the posterior semicircular canal and tissue graft. Another fascia graft is placed over the repair for extra support.
The inner ear is preserved. If the patient has been properly selected, results are positive.
Recovery from semicircular canal occlusion
Patients will need to stay in the hospital one to three days after a semicircular canal occlusion. While you may be able to move around after surgery, you may have temporary trouble balancing.
You may also experience hearing loss after surgery. While most people will regain hearing gradually after surgery, some people will experience permanent hearing loss.