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

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.