Abstract

Benign paroxysmal positional vertigo (BPPV) is the most frequent vestibular disorder. Although it is easily cured with canal repositioning maneuvers for the majority of patients, it can be disabling in rare cases. For these patients, surgical treatments may be proposed. The aim of this article is to discuss their indication in intractable BPPV and review the surgical treatments used, the reported cases in the literature. All the articles from 1972 to 2013 that discussed specific surgical treatments in BPPV were reviewed. Many of them reported cases of operated patients and described original techniques. Some others are studies that discussed the three techniques used: singular neurectomy, posterior semicircular canal occlusion and intratympanic injection of gentamicin. Singular neurectomy and posterior semicircular canal occlusion are the two specific techniques used in intractable BPPV. A very small population of patients requires surgical treatments of BPPV. These procedures are difficult and risk compromising hearing. The intratympanic injection of gentamicin can be useful procedure in BPPV associated with Meniere disease. The surgical treatments of BPPV appear to be limited to exceptional cases. When good examination and appropriate treatment fail to cure patients with intractable BPPV, central positional vertigo should be ruled out before irreversible surgical procedures.

• Keywords: Benign paroxysmal positional vertigo;Surgery;Therapy;